液基细胞学和高危型HPV-DNA检测在宫颈病变筛查中的应用  

Application of Liquid Based Cytology and High-risk Human Papillomavirus DNA Test for the Screening Cervical Lesions

作　　者：陈海燕[1] 王燕[2] 

机构地区：[1]北京市普仁医院,北京100062 [2]北京大学医学部公共卫生学院,北京100083

出　　处：《中国医药导刊》2010年第9期1592-1593,1595,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨液基细胞薄层涂片(ThinPrep Cytology Test,TCT)和高危型人乳头状瘤病毒(HR-HPV)检测在宫颈病变筛查中的作用。方法:采用宫颈超薄液基细胞学检测及第二代杂交捕获试验(HC-Ⅱ)对1794例妇女进行宫颈病变筛查,以宫颈组织病理学检查结果作为确诊的金标准。结果:细胞学检查发现非典型鳞状细胞(ASCUS)159例,低度鳞状上皮内瘤变(LSIL)69例,高度鳞状上皮内瘤变(HSIL)34例。病理学证实CINⅠ104例,CINⅡ21例,CINⅢ18例,宫颈鳞状细胞癌4例。高危型HPV-DNA在不同宫颈病变中的阳性率分别是:宫颈癌100.0%(4/4),高度鳞状上皮内瘤变HSIL37/39(94.9%),低度鳞状上皮内瘤变LSIL93/104(89,4%)。宫颈液基细胞学筛查宫颈病变的灵敏度为89.1%,特异度为91.8%,阴性预测值为99.0%;高危型HPV-DNA检测宫颈病变的敏感性为91.2%,特异性为85.5%,阴性预测值为99.1%,宫颈液基细胞学与高危型HPV-DNA检测共同使用的敏感性为99.3%,特异性为82.6%,阴性预测值为99.9%。结论:液基细胞学与高危型HPV-DNA检测同时应用,可使灵敏度和阴性预测值有所提高,其结果对宫颈病变有预警作用。Objective：To explore the application of ThinPrep Cytology Test （TCT） and high-risk human papillomavirus（HR-HPV） DNA test for the screening cervical lesions.Methods：1 794 women were monitored by Thinprep liquid based cytology and hybrid capture lI,taking biopsy pathology result as golden standard.Results：In 1 794 women, by Thinprep liquid based cytology 159,69 and 34 women were found to be ASCUS,LSIL and HSILrespectively.By biopsy under the celpascope 104.21 and 18 women were diagnosed as CINI,CtNII and CINIIl,resp ectively, while 4 women were diagnosed as squamous cervical cancer：The infection rate of HR-HPV Was 100.0%（4/4） in SCC patients, 94.9% （37/39） in HSIL patients.89.4%（93/104） in LSIL patients.For Thinprep liquid based cytology.the sensitivity, specificity and negative predictive values were 89.1%,91.8% and 99.0% respectively, The sensitivity ,specificity and negative predictive values of HR-HPV were 91.2%.85.5% and 99.1% respectively.Additionally, the sensitivity ,specificity and negative predictive values were 99.3%,82.6% and 99.9% by HR- HPV combined Thinprep liquid based cytology.Conclusion：Combining Thinprep liquid based cytology with HR-HPV-DNA test may increase the sensitivity and negative predictive value for detecting cervical lesions.

关 键 词：液基细胞薄层涂片 人乳头瘤病毒 宫颈病变 筛查 

分 类 号：R737.33[医药卫生—肿瘤] R36[医药卫生—临床医学]