TCT与HR-HPV联合检测对宫颈癌筛查的意义  

Role of combined use of TCT and HR-HPV testing in screening cervical cancer

作　　者：胡静熠[1] 吴江平[1] 

机构地区：[1]南京医科大学附属南京妇幼保健院妇保所,江苏省210004

出　　处：《江苏医药》2012年第24期2988-2990,共3页Jiangsu Medical Journal

摘　　要：目的探讨液基薄层细胞学技术(TCT)与高危型人乳头状瘤病毒(HR-HPV)联合检测对筛查宫颈癌和宫颈早期病变的临床意义。方法宫颈癌普查的体检者520例,采用TCT和HR-HPV分型检测,后者用导流杂交基因芯片技术(HybriMax)。分析联合检测对宫颈早期病变筛查的价值。结果 TCT检测中有148例出现细胞学异常,检出率28.5%(148/520);其中,非典型鳞状细胞癌(ASC)105例,低度鳞状上皮内病变(LSIL)32例,高度鳞状上皮内病变(HSIL)10例,宫颈鳞状细胞癌(SCC)1例。HR-HPV阳性率39.8%(207/520)。TCT阳性结果病例中,HR-HPV的阳性率分别为ASC 77.1%(81/105),LSIL 84.4%(27/32),HSIL 90.0%(9/10),SCC 100.0%(1/1)。HR-HPV的阳性率随着宫颈病变级别增高而增高。结论 HR-HPV阳性率与细胞学分级密切相关;HR-HPV检测能降低TCT检测的假阴性率,两者联合检测对宫颈癌和宫颈病变的早期诊断有重要意义。Objective To investigate the clinical significance of thin prep liquid-based cytology test（TCT） combined with high-risk human papillomavirus（HR-HPV） in the diagnosis of cervical cancer and cervical early lesions. Methods Cervical cytological examination and HR-HPV testing were carried out by TCT and flow-through hybrization and gene chip （HybriMax） in 520 women. Results The cytological abnormity was reported by TCT in 148 cases with an inspection rate of 28. 5 ~ （148/520）, of whom atypical squamous cell（ASC） was found in 105 cases, low-grade squamous intraepithelial lesion（LSIL） in 32 cases, HSIL high-grade squamous intraepithelial lesion（HSIL） in 10 cases, and cervical squamous cells cancer（SCC） in 1 case. In the positive cases reported by TCT test, HR-HPV positive was detected in 77, 1%（81/105） for ASC,84. 4%（27/32） for LSIL,90. 0%（9/10） for HSIL, and 100.0% （1/1） for SCC. The positive rate of HR-HPV was increased as the grade of cervical cytology increased. Conclusion The positive rate of HR-HPV is closely associated with the grade of cervical cytological abnormity. The false negative rate of TCT test can be reduced by HR-HPV detection. Combined examination of HR-HPV and TCT test is valuable in the early diagnosis of cervical cancer and cervical lesions.

关 键 词：宫颈癌 液基薄层细胞学技术 高危型人乳头状瘤病毒 

分 类 号：R737[医药卫生—肿瘤]