高危型HPV-DNA联合TCT检查对高级别宫颈鳞状上皮内病变LEEP术后复发预测价值  

Predictive value of high-risk HPV-DNA combined with TCT examination for high-grade cervical squamous intraepithelial lesions after LEEP recurrence

作　　者：金友存 华玉蓉 王佩佩 张丽娜 JIN You-cun;HUA Yu-rong;WANG Pei-pei;ZHANG Li-na(Department of Obstetrics and Gynecology,Affiliated Hospital of Jiangnan University,Wuxi 214000,Jiangsu,China;Department of Gynecology,Changzhou Maternal and Child Health Hospital,Changzhou 213000,Jiangsu,China)

机构地区：[1]江南大学附属医院妇产科,无锡214000 [2]常州市妇幼保健院妇科,常州213000

出　　处：《医学研究生学报》2022年第11期1185-1189,共5页Journal of Medical Postgraduates

摘　　要：目的目前国内尚缺乏高危型人乳头状瘤病毒(HR-HPV)联合液基薄层细胞学检测(TCT)检查对高级别宫颈鳞状上皮内瘤样病变(HCSIL)患者宫颈环形电切除(LEEP)术后复发的预测价值报道。文中旨在探讨HR-HPV-DNA联合TCT对HCSIL LEEP术后复发预测价值。方法选取2018年1月至2020年1月江南大学附属医院妇产科收治的164例HCSIL患者为研究对象,所有患者均行LEEP治疗,术前采用第二代杂交捕获法行HR-HPV-DNA检查,术前TCT检查采用Bethesda分级系统法,术后随访12个月。统计治疗6个月后复发情况;HCSIL患者LEEP术前HR-HPV-DNA、TCT检查结果;比较复发者与未复发者术前HR-HPV-DNA、TCT阳性情况;分析HR-HPV-DNA联合TCT检查对HCSIL LEEP术后复发的预测价值。结果行LEEP术治疗的HCSIL患者治疗6个月后复发率为19.51%(32/164)。HCSIL患者LEEP术前HR-HPV-DNA阳性率为52.44%(86/164),术前TCT检查阳性率为74.39%(122/164)。复发者HR-HPV-DNA、TCT阳性率高于未复发者(P<0.05)。HR-HPV-DNA、TCT及两者联合预测HCSIL LEEP术后复发的灵敏度分别为87.50%、93.75%、93.75%,特异度分别为56.06%、43.48%、96.97%。结论HR-HPV-DNA联合TCT检查是预测HCSIL患者LEEP术后复发的有效手段,两者联合检查对HCSIL患者LEEP术后复发具有较高预测价值。Objective To explore the value of high-risk human papillomavirus(HR-HPV)DNA combined with liquid-based thin-layer cytology(TCT)in predicting the recurrence of high-grade cervical squamous intraepithelial lesions(HCSIL)after loop electrocervical excision procedure(LEEP).Methods A total of 164 HCSIL patients admitted to Affiliated Hospital of Jiangnan University were selected as the research subjects from January 2018 to January 2020.All patients were given LEEP treatment,HR-HPV-DNA examination was performed by the second-generation hybrid capture method before the operation,and the Bethesda grading system method was used for the preoperative TCT examination,and were followed up for 12 months after surgery.Recurrence was counted after 6 months of treatment.The HR-HPV-DNA and TCT examinations of HCSIL patients before LEEP were counted.The positive status of HR-HPV-DNA and TCT was compared between relapsed patients and non-relapsed patients.The predictive value of HR-HPV-DNA combined with TCT examination for HCSIL LEEP postoperative recurrence was analyzed.Results The recurrence rate of HCSIL patients who underwent LEEP treatment was 19.51%(32/164)after 6 months of treatment.The positive rate of HR-HPV-DNA in 82 HCSIL patients before LEEP was 52.44%(86/164),and the positive rate of TCT before operation was 74.39%(122/164).The positive rates of HR-HPV-DNA and TCT in relapsed patients were higher than those in non-relapsed patients(87.50%vs 43.94%,93.75%vs 69.70%,both P<0.05).The sensitivities of HR-HPV-DNA,TCT and their combination in predicting postoperative recurrence of HCSIL LEEP were 87.50%,93.75%,and 93.75%,the specificities were 56.06%,43.48%,and 96.97%,respectively.Conclusion HR-HPV-DNA combined with TCT examination is an effective method for predicting the recurrence of HCSIL patients after LEEP surgery.The combined examination of the two methods has a high predictive value for the recurrence of HCSIL patients after LEEP surgery.

关 键 词：高危型人乳头状瘤病毒 液基薄层细胞学检测 高级别宫颈鳞状上皮内瘤样病变 宫颈环形电切除术 复发 预测价值 

分 类 号：R373[医药卫生—病原生物学]