液基薄层细胞学技术联合HPV DNA检测在诊断高级别宫颈病变中的临床价值  

Clinical value of liquid based thin layer cytology combined with HPV DNA detection in the diagnosis of high-grade cervical lesions

作　　者：魏爱婷[1] 王富伟[1] WEI Ai-ting(Clinical laboratory,the third affiliated hospital of Luohe Medical College,462002,China)

机构地区：[1]漯河医学高等专科学校第三附属医院检验科,河南漯河462002

出　　处：《齐齐哈尔医学院学报》2021年第11期965-968,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨液基薄层细胞学、HPV DNA检测在诊断高级别宫颈病变中的临床价值。方法选取2016年2月—2018年6月在本院同时进行常规新柏氏宫颈液基细胞学检测(TCT)及HPV DNA检测,并追踪到具有组织学检查结果的439例患者为研究对象,将其分为正常/慢性炎症组、CIN1组、CIN2组、CIN3组和SCC组,其中正常/慢性炎症组194例,CIN1组97例,CIN2组56例,CIN3组73例,SCC组19例。分别采用液基薄层细胞学技术及2001版Bethesda分类系统对患者进行细胞学诊断,采用第二代杂交捕获法(HC2)检测HPV DNA。比较细胞学检测与HPV DNA检测结果、细胞学检测与组织学检测结果、HPV DNA检测与组织学检测结果和细胞学检测、HPV DNA检测及两种方法联合检测诊断CIN2+的价值。结果正常/慢性炎症组、CIN1、CIN2、CIN3和SCC组细胞学阳性率和HPV DNA阳性率分别为39.2%、70.1%、87.5%、87.7%、100%和57.7%、73.2%、94.6%、90.4%、100%;HPV DNA检测和细胞学诊断级别间、细胞学检测和组织学检测、HPV DNA检测和组织学检测的关联系数分别为0.348、0.625和0.333(P<0.001);以组织学为金标准,检测CIN2+,细胞学检测、HPV DNA检测和两者联合检测相比,仅细胞学和HPV DNA检测的特异性间,及联合检测与细胞学检测的敏感性、特异性差异具有统计学意义(P<0.05)。结论液基细胞学和高危HPV DNA检测方法可互为补充,两者联合检测可以提高女性宫颈癌筛查准确性。Objective To investigate the clinical value of liquid based thin layer cytology and HPV DNA detection in the diagnosis of high-grade cervical lesions.Methods From February 2016 to June 2018,439 patients received both routine thinprep cytologic test(TCT)and HPV DNA detection in our hospital and those had histological test results were enrolled as study subjects.They were divided into normal/chronic inflammation group(194),CIN1 group(97),CIN2 group(56),CIN3 group(73)and SCC group(19).Liquid based thin layer cytology and 2001 edition Bethesda classification system were used for cytological diagnosis,and the second generation hybrid capture II(HC2)method was used to detect HPV DNA.The differences among the results of cytology detection,HPV DNA detection,and histology were compared.Finally explored the value of cytology detection,HPV DNA detection,and the combination of the two methods in the diagnosis of CIN2+.Results The positive rates of cytology in normal/chronic inflammation group,CIN1,CIN2,CIN3 and SCC group were 39.2%,70.1%,87.5%,87.7%,and 100%,respectively.And the positive rates of HPV DNA in those groups were 57.7%,73.2%,94.6%,90.4%,and 100%,respectively.The correlation coefficients between HPV DNA test and cytological diagnosis,cytological test and histological test,HPV DNA test and histological test were 0.348,0.625 and 0.333,respectively(all P<0.001).The differences in the specificity between cytology and HPV DNA detection,and the differences in the specificity and sensibility between the combination detection and cytology detection,were statistically significant(P<0.05).Conclusions Liquid based cytology and high-risk HPV DNA detection methods could complement each other,and the combined detection of the two methods could improve the accuracy of female cervical cancer screening.

关 键 词：液基细胞学 HPV DNA 宫颈病变 宫颈癌 

分 类 号：R711.74[医药卫生—妇产科学]