高危型HPV联合TCT在宫颈癌筛查中的价值研究  

Value of high risk HPV combined with Thin Prep cytology test in cervical cancer screening

作　　者：王艳君[1] 张静[1] 

机构地区：[1]宝鸡市中心医院妇科,陕西宝鸡721008

出　　处：《中国性科学》2017年第12期24-27,共4页Chinese Journal of Human Sexuality

摘　　要：目的:探讨高危型人乳头瘤病毒(HPV)联合液基薄层细胞检测技术(TCT)在宫颈癌筛查中的价值。方法:选择2014年6月至2016年12月在我院就诊接受HR-HPV及TCT检测的1426例患者,并行阴道镜活检做病理组织学诊断,对TCT、HR-HPV以及TCT联合HR-HPV检测结果分析。结果:从CINⅠ级、CINⅡ级、CINⅢ级至SCC患者TCT检测阳性率呈显著升高趋势,与宫颈炎组比较差异均具有统计学意义(P<0.05)。在多重感染患者中,其CINⅠ级、CINⅡ级、CINⅢ级至SCC患者HPV感染率显著高于宫颈炎组,比较差异均具有统计学意义(P<0.05),患者随着CIN分级的增加HR-HPV检测阳性率而显著升高,与宫颈炎组比较差异均具有统计学意义(P<0.05)。在TCT联合HPV检测中,CINⅠ~CINⅢ级及SCC组HPV感染均非常显著高于宫颈炎组,比较差异均具有统计学意义(P<0.05)。TCT联合HR-HPV检测在灵敏度、特异度、阳性预测值、阴性预测值均显著优于TCT、HR-HPV单独检测,比较差异均具有统计学意义(P<0.05)。结论:高危型HPV联合TCT在宫颈癌筛查中较单一检测可明显减少漏诊率、误诊率,使宫颈癌前病变患者早期介入治疗,降低宫颈癌患者发病率及病死率。Objectives： To investigate the value of high risk human papillomavirus（ HPV） combined with Thin Prep cytology test（ TCT） in the screening of cervical cancer. Methods： 1426 patients who underwent HR-HPV and TCT examination in our hospital from June 2014 December 2016 were selected. The colposcopy biopsy histopathological diagnosis was conducted. The results of HR-HPV,TCT and HR-HPV combined TCT were analyzed. Results： The positive rate of TCT detection increased with the increasing of CIN grade,and the difference was statistically significant compared with that in cervicitis group（ P 0. 05）. In patients with multiple infections,HPV infection rate in CIN I,CIN II,CIN III and SCC patients was significantly higher than that of cervicitis group,and the difference was statistically significant（ P 0. 05）. HR-HPV positive rate increased with the increasing of CIN grade. Compared with cervicitis group,the difference was statistically significant（ P 0. 05）. In the detection of TCT combined with HPV,the levels of HPV infection in CIN I,CIN II,CIN III and SCC group were significantly higher than those in cervicitis group,and the difference was statistically significant（ P 0. 05）. The sensitivity,specificity,positive predictive value and negative predictive value of TCT combined with HR-HPV were significantly better than those of TCT or HR-HPV,and the differences were statistically significant（ P 0. 05）.Conclusion： High risk HPV combined with TCT in cervical cancer screening can significantly reduce the rate of missed diagnosis and misdiagnosis rate,so that patients with cervical precancerous lesions can achieve early intervention. The incidence and mortality of cervical cancer can be reduced.

关 键 词：高危HPV TCT 宫颈癌筛查 阴道镜活检 

分 类 号：R737.33[医药卫生—肿瘤]