LCT+HPV联合筛查体检人群在宫颈病变诊断中的作用  

The diagnostic value of high rate Human papillomavirus(HPV) combined to Liquid-based Cytology Test(LCT) for cervical cancer screening in healthy crowd

作　　者：陈玉芬[1] 张礼婕[1] 刘志红[1] 李环[1] 吴瑞芳[1] 

机构地区：[1]北京大学深圳医院妇产科,广东深圳518000

出　　处：《罕少疾病杂志》2010年第6期5-9,共5页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨LCT+HPV联合筛查体检人群在宫颈病变诊断中的作用。方法对2005年4月-2006年10月期间在我院体检中心同时进行LCT+HPV联合筛查宫颈癌的正常人群进行普查,对其中任一项阳性的225例体检人群进行光电一体阴道镜检查并以组织学诊断为金标准进行分析,探讨深圳市体检人群HPV感染情况与宫颈病变的发病情况。结果我院体检人群HPV感染率15.81%,不同年龄段HPV感染率、宫颈高度病变的发生率不同和(或)不全相同,p>0.05,统计学差异无显著性;LCT异常诊断率13.74%,LCT诊断级别升高,HPV感染率、宫颈高度病变发生率显著增高,p<0.05,差异显著,有统计学意义;LCT(LCT≥LSIL)、HPV、LCT+HPV(LCT≥LSIL)筛查宫颈高度病变的灵敏度、特异度、阴性预测值、阳性预测值分别为67.44%、97.67%、82.56%;67.21%、14.84%、41.21%;89.78%、96.43%、90.91%;32.95%、21.32%、24.91%。结论宫颈高度病变的发生集中在生育及性活跃期,也趋于年轻化,处于此年龄段的妇女应重视体检筛查。HPV感染与低度病变高危人群,建议定期跟踪随访,防止宫颈癌的发生;LCT+HPV联合筛查进行宫颈癌普查工作,可大大提高从正常人群体查中宫颈高度病变的诊断率,降低漏诊率,二者结合将更有利于宫颈病变的分流管理。Objective The purpose of this study was to investigate high rate Human papillomavirus（HPV） combined to Liquid-based Cytology Test（LCT） for cervical cancer screening in healthy crowd.Method The study was conducted HPV combined to LCT for cervical cancer screening on healthy crowd women in our health examination center during the period April 2005 to October 2006.225 cases that any test is positive,were performed colposcopy and then took cervical biopsy on any colposcopically suspicious area.Took the cervical biopsy pathology results as the golden criteria.Analysis the HPV infection rates and cervical lesion incidence in Shenzhen city.Result The HPV infection rates is 15.81%,there are no significant with p0.05 in different age groups＇ HPV infection rates,cervical lesion incidence.The abnormal rates in LCT is 13.74%.HPV infection rates and cervical lesion incidence enhanced with the diagnosis grade of LCT,significant with p〈0.05.The sensitivity,specificity,positive predictive value and negative predictive value of LCT（LCT≥LSIL）、HPV、LCT＋HPV（LCT≥LSIL）are 67.44%,97.67%,82.56%;67.21%、14.84%、41.21%;89.78%、96.43%、90.91%;32.95% 、21.32%、24.91%.Conclusion High grade cervical lesion happened n younger women,who are in high reproductive and sexually active period.So women in this age should pay more attention in health examination.Women with HPV infection and low grade cervical lesion should follow up to avoid cervical cancer.HPV combined to LCT for cervical cancer screening could improve the diagnosis rate,reduce the ratio of failure diagnosis,convenient with scattering the patients.

关 键 词：液基细胞学(LCT) 人乳头状瘤病毒(HPV) 活组织检查 体检人群 

分 类 号：R737.33[医药卫生—肿瘤]