内蒙古地区液基细胞学与人乳头瘤病毒分型检测筛查宫颈癌的对比研究  

Comparative study of the effect of cervical cancer screening by Liquid-Based Cytology and High-Risk Human papillomavirus detection in Inner Mongolia

作　　者：宋艳波[1] 王少明[2] 董丹 张永东[4] 段仙芝[3] 

机构地区：[1]北京市大兴区亦庄医院,100176 [2]国家癌症中心,中国医学科学院肿瘤医院 [3]首都医科大学附属北京同仁医院 [4]内蒙古准格尔旗人口与计划生育局

出　　处：《中国妇产科临床杂志》2016年第1期10-13,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：中华人民共和国卫生和计划生育委员会:面向农村和城市社区推广适宜技术十年百项计划(2004-01)

摘　　要：目的对比采用液基细胞学与高危型人乳头瘤病毒（HPV）分型检测技术在内蒙古地区筛查宫颈癌的效果,为该地区宫颈癌初筛方法的选择提供依据。方法 2012年4月至2014年5月,在内蒙古准格尔旗地区招募30 118名20~70岁妇女,同时采用液基细胞学和Cervista HPV分型检测的方法进行宫颈癌筛查,对细胞学结果异常或HPV检测阳性的女性召回行阴道镜检查,阴道镜下病理活检确诊为金标准。结果液基细胞学总阳性率为5.54%,HPV总阳性率为23.18%,A9型为最常见的HPV感染型别为7.77%,蒙族与汉族HPV感染的优势型别排序相同。HPV总感染率和A9型HPV感染率均与细胞学病变级别正相关。随病理级别的增高,A9型分组的阳性率显著增高。液基细胞学与Cervista HPV检测与对高度宫颈上皮内瘤变（CIN2＋）诊断的一致性很高（84.71%）,且在诊断CIN2＋上有互补作用,有26例CIN2＋患者被细胞学漏诊但HPV检测阳性,19例HPV检测未获得阳性结果但被液基细胞学发现,二者联合检测可提高CIN2＋的检出率（98.47%vs 84.71%,P〈0.05）。结论液基细胞学与Cervista检测筛查宫颈癌的一致性很高,可根据不同地区的卫生资源情况应用于宫颈癌筛查,联合应用可提高CIN2＋的检出率。Objective To investigate the effect of cervical cancer screening by liquid-based cytology and highrisk human papillomavirus（HPV）detection in Inner Mongolia,and to provide scientific data for the selection of primary screening technologies of cervical cancer in Inner Mongolia.Methods From April.2012 to May 2014,30118 women aged 20~70were screened by the Thinprep liquid-based cytology（TCT）and the Cervista HPV detective method for cervical cancer in Inner Mongolia.Those with abnormal cytological results or HPV infection were referred to colposcopy examination,and biopsy was taken for pathological confirmation.Results The rate of positive cytology result and HPV infection was 5.54% and 23.18%,respectively.A9 group was the most common HPV types with a positive rate of 7.77%.The predominated HPV types was the same for the Han nationality and Mongolian.Both the total HPV infection rate and A9 group HPV infection rate were positively associated with the grade of cytological abnormity.The positivity of A9 HPV type was increased by the pathological grades.The consistence（84.71%）between TCT and Cervista for the detection of high grade cervical intraepithelial neoplasia（CIN2＋）was high.The two methods worked as supplementary for each other.Twenty-six cases were detected by the HPV test while missed by TCT,and 19 cases with negative HPV results were found abnormal by TCT.The combination of the two methods increased the detective rate of CIN2＋ from 84.71% to 98.47%（P〈0.05）.Conclusions The consistence of TCT and Cervista for the detection of CIN2＋ was good.TCT and Cervista can be used as effective methods for cervical cancer screening in various areas with different health resources,and their combination can increase the accuracy.

关 键 词：液基细胞学 Cervista高危型HPV检测 宫颈癌 筛查 内蒙古地区 

分 类 号：R737.33[医药卫生—肿瘤]