液基细胞学与高危型HPV-DNA联合检测在宫颈病变筛查中的意义  

The clinical significance of TCT joint the high-risk HPV-DNA detection in cervical lesions screening

作　　者：喻垚[1] 郭变琴[1] 罗光丽[1] 赖年钰[1] 

机构地区：[1]重庆市肿瘤研究所检验科,400030

出　　处：《检验医学与临床》2015年第11期1550-1551,1554,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨薄层液基细胞学(TCT)与高危型人乳头状瘤病毒(HR-HPV)DNA检测在宫颈病变筛查中的临床意义。方法 2012年1月至2014年1月该院就诊的宫颈病变患者1 343例,其中临床已病理确诊的宫颈癌386例,宫颈炎555例,CINⅠ269例,CINⅡ/Ⅲ133例,对所有患者均采用TCT法检测细胞病变,同时使用第2代杂交捕获法(HC2)检测高危型HPV-DNA的阳性表达率,并比较2种方法的敏感性、特异性、阳性预测值和阴性预测值。结果高危型HPV-DNA在宫颈炎、CINⅠ、CINⅡ/Ⅲ和宫颈癌中的阳性率分别为26.5%、48.7%、54.9%、72.0%,4组患者之间比较,差异有统计学意义(P<0.01);TCT与高危型HPV-DNA联合检测其敏感性为80.2%,特异性为88.5%,阳性预测值86.7%,阴性预测值81.3%,均比单独检测值有所增高。结论 TCT与高危型HPV-DNA联合检测可提高检出率,对宫颈癌的预防和治疗具有重要意义。Objective To study the clinical significance of TCT and the high-risk HPV-DNA detection in cer- vical lesions screening. Methods There were 386 cases of cervical cancer,555 cases of clinical cervicitis,269 cases of CIN I , 133 cases of CIN Ⅱ/Ⅲ, all have been confirmed by histopathological diagnosis. We detected the cytology lesions through Thinprep cytology test （TCT）, and detected the expression of high-risk HPV-DNA through second- generation hybrid capture Ⅱ（hybrid captme, HC Ⅱ ）. Results The positive expression rates of high-risk HPV-DNA in cervicitis, CIN I , CIN Ⅱ/Ⅲ , cervical cancer were 26.5 %, 48.7%, 54.9 %, 72.0 %, and there were statistically sig nificance in the four groups （P〈0.01）. In screening CIN I or above, sensitivity, specificity, PPV and NPV of HR- HPV detection combined with cytology were 80. 2%, 88. 5%, 86. 7%, 81. 3 %, and higher than the separate detec- tion. Conclusion Infection rate of HR-HPV is ascending with serious degree of cervical lesion. HR-HPV detection by HC- Ⅱ is an important method in screening cervical lesion. Combined TCT and HR-HPV test will improve the detec- tion rate of cervical lesions,it is an ideal method to screening cervical cancer and prevention.

关 键 词：TCT HPV-DNA 宫颈病变 宫颈癌 

分 类 号：R6[医药卫生—外科学]