TCT、HPV-DNA分型联合阴道镜检查在宫颈病变筛查中的应用价值  

Application value of TCT, HPV-DNA typing combined with colposcopy in screening cervical lesions

作　　者：吴志东[1] 吴振勇[1] 黄彩凤[1] 温丽娟[1] 郑戈[1] WU Zhi-dong;WU Zhen-yong;HUANG Cai-feng;WEN Li-juan;ZHENG Ge(Department of Clinical Laboratory,Guangzhou Development Zone Hospital,Guangdong Province,Guangzhou 510730,China)

机构地区：[1]广州开发区医院检验科,广东广州510730

出　　处：《中国当代医药》2019年第6期133-136,共4页China Modern Medicine

摘　　要：目的分析液基薄层细胞检测(TCT)、人乳头瘤病毒分型检测(HPV-DNA)联合阴道镜检查对宫颈病变筛查的临床应用价值。方法选取2017年1月～2018年6月我院同时做TCT、HPV-DNA分型和阴道镜检查的700例患者作为研究对象,对检查异常者做病理学检查,以病理学结果及分级为诊断结果。结果 700例TCT阳性检出率为17.1%(120例),包括无明确意义的非典型细胞的改变(ASCUS)阳性率为12.7%(89例),低度鳞状上皮内病变(LSIL)阳性率为3.0%(21例),高度鳞状上皮内病变(HSIL)阳性率为1.1%(8例),鳞状细胞癌(SCC)阳性率为0.3%(2例),另外HPV-DNA阳性检出率为7.4%(52例),阴道镜阳性率为9.6%(67例)。其后的病理活检中CINⅠ检出率2.9%(20例),CINⅡ检出率为1.9%(13例),CINⅢ检出率为1.0%(7例),浸润癌检出率为0.6%(4例);HPV-DNA阳性的CINⅠ检出率为2.0%(14例),CINⅡ检出率为1.3%(9例),CINⅢ检出率为0.6%(4例)及浸润癌检出率为0.3%(2例)。TCT、HPV联合阴道镜检查的病理结果准确率高于常规TCT联合HPV检查,差异有统计学意义(P<0.05);两者浸润癌的检测结果比较,差异无统计学意义(P>0.05)。三者中以TCT灵敏度最高,其次为阴道镜,HPV-DNA分型灵敏度最低;以阴道镜特异度最高,其次为HPV-DNA分型,TCT特异度最低。结论TCT、HPV-DNA分型、阴道镜3者联合检查能有效提高宫颈病变阳性检出率,是一种高效的宫颈病变筛查方法 ,有重要的临床应用价值,值得推广。Objective To analyze the clinical application value of liquid-based thin-layer cell detection(TCT),human papillomavirus typing(HPV-DNA)typing combined with colposcopy for cervical lesion screening.Methods A total of 700 patients who underwent TCT,HPV-DNA typing and colposcopy in our hospital from January 2017 to June 2018 were enrolled.Pathological examination was performed on those who had abnormalities,and the pathological results and grades were used as the diagnosis results.Results The positive rate of TCT in 700 subjects was 17.1%(120 cases),including no clear change of atypical cells(ASCUS),the positive rate was 12.7%(89 cases),low grade squamous epithelium(LSIL),the positive rate was 3%(21 cases),the positive rate of high squamous intraepithelial lesion(HSIL)was 1.1%(8 cases),and the positive rate of squamous cell carcinoma(SCC)was 0.3%(2 cases).The positive rate of HPV-DNA detection was 7.4%(52 cases),and the positive rate of colposcopy was 9.6%(67 cases).In the subsequent pathological biopsy,the CINⅠdetection rate was 2.9%(20 cases),the CINⅡdetection rate was 1.9(13 cases),the CINⅢdetection rate was 1.0%(7 cases),and the invasive cancer detection rate was 0.6(4 cases).HPV-DNA positive CINⅠdetection rate was 2.0%(14 cases),CINⅡdetection rate was 1.3%(9 cases),CINⅢdetection rate was 0.6%(4 cases)and invasive cancer detection rate was 0.3%(2 cases).The accuracy of pathological results of TCT and HPV combined with colposcopy was higher than that of conventional TCT combined with HPV,the difference was statistically significant(P<0.05).There was no significant difference between the two cases of invasive carcinoma(P>0.05).TCT had the highest sensitivity,followed by colposcopy,and HPV-DNA typing had the lowest sensitivity;the colposcopic specificity was the highest,followed by HPV-DNA typing,and TCT was the lowest.Conclusion The combined examination of TCT,HPV-DNA typing and colposcopy can effectively improve the positive detection rate of cervical lesions.It is an effective screening method for ce

关 键 词：液基薄层细胞检测 人乳头瘤病毒分型检测 阴道镜检查 宫颈病变 

分 类 号：R737.33[医药卫生—肿瘤]