探讨人乳头瘤病毒基因分型检测与液基细胞学检测在宫颈病变筛查中的应用  

To explore the application of human papillomavirus genotyping detection and liquid-based cytology detection in cervical lesions screening

作　　者：刘彩虹 周金华[1] Liu Caihong;Zhou Jinhua(Department of Gynecology,The First Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Obstetrics and Gynecology,Suzhou Chuantang Community Health Service Center,Suzhou 215122,China)

机构地区：[1]苏州大学附属第一医院妇产科,江苏苏州215000 [2]苏州跨塘社区卫生服务中心妇产科,江苏苏州215122

出　　处：《实用妇科内分泌电子杂志》2022年第4期121-125,共5页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探究与分析人乳头瘤病毒(HPV)基因分型检测与液基细胞学检测(TCT)在宫颈病变筛查中的应用价值。方法回顾性分析7101例35~64岁妇女接受宫颈病变筛查的临床资料,按照患者自愿方式选择筛查方法,其中TCT筛查者3480例,HPV筛查者3621例,以宫颈活检病理组织学为金标准,统计不同年龄层中宫颈病变的检出情况及HPV分型情况,并对比HPV、TCT联合检测结果与组织病理学检查结果。结果在3480例TCT筛查者中,检测结果异常80例,异常检出率为2.30%(80/3480),其中非典型鳞状上皮细胞(ACS)42例(1.21%)、低度鳞状上皮细胞内病变(LSIL)35例(1.01%)、高度鳞状上皮细胞内病变(HSIL)3例(0.09%)。在年龄分布上,HSIL患者年龄明显高于ACS、LSIL患者,差异有统计学意义(P<0.05)。在3621例HPV筛查者中,共筛查出宫颈病变469例,检出率为12.95%(469/3621),其中低位型感染中单一感染31例(0.86%),两种及以上感染18例(0.50%),高危型感染中单一感染372例(10.27%),两种及以上感染48例(1.33%)。在年龄分布上,高危型感染患者平均年龄显著低于低危型感染患者,差异有统计学意义(P<0.05)。接受宫颈活检组织病理学检查78例,其中无病变6例,存在不同程度的宫颈病变72例,检出率为92.31%(72/78),在宫颈病变中,其中宫颈炎合并息肉、乳肉状增生33例(42.31%)、LSIL 27例(34.62%)、HSIL 10例(12.82%)、宫颈癌2例(2.56%),TCT不同宫颈病变组织病理学结果对比,差异有统计学意义(P<0.05)。不同HPV类型的宫颈活检组织病理学对比,差异有统计学意义(P<0.05)。其中2例宫颈癌患者均为HPV高危型16型亚型。HPV阳性者与阴性者TCT对比,差异具有统计学意义(P<0.05)。HPV高危型与低危型TCT检测结果对比,差异具有统计学意义(P<0.05)。结论HPV与TCT均可作为临床上良好的筛查宫颈病变的方法,HPV联合TCT检测可极大程度提高宫颈病变的检出率,具有更高的应用价值。Objective To explore and analyze the application value of human papillomavirus(HPV)genotyping and liquid based cytology(TCT)in cervical lesion screening.Methods The clinical data of 7101 women aged 35~64 who underwent cervical lesion screening were analyzed retrospectively.The screening methods were selected according to the voluntary way of patients,including 3480 cases of TCT screening and 3621 cases of HPV screening.Taking cervical biopsy histopathology as the gold standard,the detection of cervical lesions and HPV typing in different age groups were counted,and the results of combined detection of HPV and TCT and histopathological examination were compared.Results Among 3480 cases of TCT screening,80 cases had abnormal results,and the abnormal detection rate was 2.30%(80/3480),including 42 cases of atypical squamous epithelial cells(ACS)(1.21%),35 cases of low-grade squamous intraepithelial lesions(LSIL)(1.01%)and 3 cases of high-grade squamous intraepithelial lesions(HSIL)(0.09%).In terms of age distribution,the age of patients with HSIL was significantly higher than that of patients with ACS and LSIL(P<0.05).Among 3621 cases of HPV screening,469 cases of cervical lesions were screened out,and the detection rate was 12.95%(469/3621),including 31 cases of single infection in low-level infection(0.86%),18 cases of two or more infections(0.50%),372 cases of single infection in high-risk infection(10.27%),and 48 cases of two or more infections(1.33%).In terms of age distribution,the average age of patients with high-risk infection was significantly lower than that of patients with low-risk infection(P<0.05).78 cases underwent cervical biopsy histopathological examination,including 6 cases without lesions and 72 cases with different degrees of cervical lesions,with a detection rate of 92.31%(72/78).Among cervical lesions,33 cases of cervicitis complicated with polyps and mammary hyperplasia(42.31%),27 cases of LSIL(34.62%),10 cases of HSIL(12.82%)and 2 cases of cervical cancer(2.56%).There was significant differe

关 键 词：宫颈病变 宫颈癌 高危型人乳头瘤病毒 液基细胞学检测 筛查 

分 类 号：R737.33[医药卫生—肿瘤]