液基薄层细胞学联合第二代基因杂交捕获法在宫颈病变筛查中的应用  

Application of a combination of LCT and HC Ⅱ for screening of cervical lesions

作　　者：张玲[1] 曹学全[1] 高琳[1] 张学斌 

机构地区：[1]台州市中心医院,浙江台州318000 [2]浙江省台州市药检所

出　　处：《中国预防医学杂志》2013年第4期301-303,共3页Chinese Preventive Medicine

基　　金：浙江省台州市科技资金补助项目(111KY07-8)

摘　　要：目的探讨液基薄层细胞学(LCT)联合第二代基因杂交捕获法(HC-Ⅱ)检测高危型人乳头瘤病毒(HR-HPV)在宫颈病变筛查中的临床价值。方法选取台州市中心医院门诊就诊患者1 500例,分为LCT组、HPV-DNA组和LCT联合HPV-DNA组,各500例。三组患者分别进行LCT检查、HPV-DNA检测和LCT联合HPV-DNA筛查,同时进行阴道镜下宫颈组织活检或宫颈管诊断性刮宫(ECC)检查。结果 LCT联合HPV-DNA组敏感性和阴性预测值均高于LCT组和HPV-DNA组,假阴性率最低。LCT联合HPV-DNA筛查阳性检出率均高于LCT组、HPV-DNA组(P均<0.05)。结论 HPV-DNA联合LCT进行宫颈病变筛查,可有效准确地提高宫颈癌和癌前病变的检出率。Objective To evaluate the clinical application of a combined liquid-based thinprep cytological test （LCT） with hybrid captureⅡ （HC-Ⅱ ） for the screening of cervical lesions caused by high risk HPV （HR- HPV） . Methods 1500 qualified OPD outpatients were evenly divided into LCT group, HPV-DNA group and LCT combined with HPV-DNA group. The patients were tested by LCT, HC-Ⅱor LCT- HC-Ⅱ accord- ingly. Meanwhile, colposcopic cervical biopsies or endocervical diagnostic curettage （ECC） test were applied to all subjects. Patients with cervical intraepithelial neoplasia I （CIN I ） of HR-HPV infection were treated locally by opin. Results The sensitivity and negative predictive value of LCT combined with HPV-DNA were both higher than that of LCT and HPV-DNA alone with the minimum false negative rate. The screening positive rate in LCT combined with HPV-DNA group was higher than that in LCT group and HPV-DNA group （P〈0.05） . Opin treatment for patients with CIN I decreased viral load, increased negative conver- sion rate and the remission rate compared to patients in control group. Conclusions The application of a combined LCT with HC- Ⅱ is able to detect more patients with cervical cancer and precancerous lesions. Opin can partly get rid of early cervical lesions and block malignant transforming of CIN I cell.

关 键 词：宫颈病变 液基薄层细胞学 第二代基因杂交捕获法 高危型人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]