液基细胞学结合人乳头瘤病毒检测在宫颈病变筛查中的诊断价值  

The diagnostic value of Thinprep Cytologic Test combined with human papillomavirus detection in the cervical lesionscreening

作　　者：武红霞 

机构地区：[1]湖北省襄阳市妇幼保健院,441021

出　　处：《检验医学与临床》2014年第A02期35-37,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨宫颈液基细胞学（TCT）检查与人乳头瘤病毒（HPV）检测在宫颈病变筛查中的诊断作用，进一步提高TCT和HPV检测水平。方法对6514例已婚妇女采用TCT检查结合酶切信号放大技术进行14种高危HPV亚型感染检测，对细胞学（TBS）诊断大于或等于ASCUS及HR—HPV检测为阳性的妇女行阴道镜下宫颈组织活检，依据细胞异型性的程度和范围进行病理学分析。结果液基细胞学诊断大于或等于ASCUS为10.6％（690／6514），宫颈液基细胞学检查结果LSIL与组织病理学结果CINI级符合率63.5％（155/244），HSIL与CIN丌级符合率69．6％（48／69）；HR-HPV阳性检出率为19．6％（1276/6514），宫颈病变以高危型HPV病毒A9组常见，HPVl6、HPV52亚型致癌性最强；HR-HPV分型检测准确性高，持续感染是引起子宫颈癌的主要原因。结论液基细胞学检查结合人乳头瘤病毒的检测能有效提高宫颈病变的检出率，对宫颈癌前病变的早期诊断有重要价值。Objective The purpose of the study is to explore the diagnostic value of Thinprep Cytologic Test （TCT）combined with human papillomavirus（HPV）detection in the cervical lesion screening and to improve the level of TCT and HPV testing. Methods A total of 6 514 married women were examined for 14 kinds of high-risk HPV subtypes infection by using TCT test combined with enzyme cutting signal amplification technology. The colposcopy and cervical biopsy were taken in the women who were positive for HR - HPV testing and the Bethesda system （TBS）diagnosis ~ASCUS. Then the pathology analysis was performed according to the degree and scope of cellular pleomorphism. Results Among the 6 514 cases, the rate of TCT≥ASCUS was 10. 6% （690/6514）. The coninci- dence rate of Low-grade squamous intraepithelial lesions（ HSIL） detected by Cervical TCT and Cervical intraepithelial neoplasia（CIN）identified by the histopathological test was up to 63.5% （155/244）. The conincidence rate of HSIL and CINII was 69.6%（48/69）. The positive rate of HR - HPV testing was 19.6（1 276/6 514）. High-risk viruse A9 group is common in the cervical lesion. HPV16 and HPV52 subtype have the strongest carcinogenicity. Typing of HR-HPV is accuracy. Persistent infection is the main cause of cervical cancer. Conclusion TCT combined with HPV detection can Improve the detection rate of cervical lesions. Which is important for the early diagnosis of cervical cancer lesion.

关 键 词：液基细胞 人乳头瘤病毒 筛查 宫颈病变 

分 类 号：R711.74[医药卫生—妇产科学]