HR-HPV DNA PCR联合TCT检测对宫颈癌前病变的诊断价值  

The significance of TCT combined with HR-HPV DNA PCR determination for the diagnosis of precancerous lesions

作　　者：陈炎添[1] 陈青龙[1] 熊燕[1] 苏雪棠[1] 黄伟刚[1] 石胜[1] 郭翼华[1] 陈荣策[1] 

机构地区：[1]江门市人民医院检验科,广东江门529020

出　　处：《检验医学》2013年第6期516-518,共3页Laboratory Medicine

摘　　要：目的探讨高危型人乳头瘤病毒(HR-HPV)DNA聚合酶链反应(PCR)联合液基薄层细胞学检查(TCT)对宫颈癌前病变筛查的应用与诊断价值。方法对540例TCT结果为非典型鳞状上皮细胞(ASCUS)及以上的患者进行HR-HPV DNA PCR检测,并对检测结果进行分析。结果 TCT阳性合并HPV阳性患者共259例,其中ASCUS、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC)的例数(阳性率)分别为155例(59.8%)、81例(31.3%)、15例(5.8%)、8例(3.1%);259例患者中ASCUS、LSIL、HSIL、SCC合并HR-HPV的阳性例数(阳性率)分别为28例(18.1%)、20例(24.7%)、10例(66.7%)、8例(100.0%)。HR-HPV和TCT单独检测的敏感性与两者联合检测的敏感性比较,差异具有统计学意义(P<0.05)。HR-HPV、TCT及两者联合检测的阳性预测值分别为25.5%、11.1%、28.2%,阴性预测值分别为68.8%、59.2%、40.8%。结论TCT与HR-HPV DNA PCR检测是筛查宫颈病变的有效方法,能最大程度地发现宫颈异常细胞并及时发现宫颈癌的诱因。Objective To investigate the application and significance of high risk human papilloma virus （HR- HPV） DNA polymerase chain reaction （PCR） combined thinprep cytology test（TCT） determination for the diagnosis of precancerous lesions. Methods A total of 540 patients undergoing TCT determination and showing positive atypical squamous cells of undetermined significance（ASCUS） and above were enrolled and performed HR-HPV DNA PCR, and the results were analyzed. Results The number of TCT positive combined HPV positive was 259 cases, including ASCUS 155 cases （ 59.8 %e ） , low-grade squamous intraepithelial lesion （LSIL） 81 cases （ 31.3 % ） , high-grade squamous intraepithelial lesion （HSIL） 15 cases （5.8%） and squamous cell carcinoma （SCC） 8 cases （3.1%）. In the 259 cases, the positive rates of ASCUS,LSIL,HSIL and SCC were 18.1% （28 cases）, 24.7% （20 cases）, 66.7% （10 cases） and 100.0% （8 cases）, respectively. The sensitivity of the combination determination of the 2 methods was higher than the sensitivities of HR-HPV determination and TCT determination with statistical significance （ P 〈 0.05 ）. The positive predictive values of HR-HPV determination, TCT determination and the combination determination of the 2 methods were 25.5% , 11.1% and 28.2% ,respectively, and the negative predictive values were 68.8% , 59.2% and 40.8% ,respectively. Conclusions TCT combined with HR-HPV DNA PCR in the diagnosis of precancerous lesions is an effective method. It is an approach for the diagnosis of early cervical cancer and precancerous lesions.

关 键 词：聚合酶链反应 液基薄层细胞学检查 高危型人乳头瘤病毒 宫颈癌 诊断 

分 类 号：R446.5[医药卫生—诊断学]