TCT联合HPV检查对宫颈高危病变的诊断价值  

Diagnostic value of TCT combined with HPV in high risk cervical lesions

作　　者：周德祥 程海霞 包涵 ZHOU De-xiang;CHENG Hai-xia;BAO Han(Pathology Department,Tianjin Binhai New Area Hospital of Traditional Chinese Medicine(Fourth Affiliated Hospital of Tianjin University of Traditional Chinese Medicine),Tianjin 300453,China)

机构地区：[1]天津市滨海新区中医医院(天津中医药大学第四附属医院)病理科,天津300453

出　　处：《中国城乡企业卫生》2022年第12期8-12,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的研究液基薄层细胞学检测(TCT)联合人乳头瘤病毒(HPV)检查对宫颈高危病变的临床诊断价值,为宫颈高危病变的诊断提供参考方案。方法选取2021年7月—2022年7月在天津市滨海新区中医医院妇科进行TCT及HPV-DNA检查的2123名女性患者,分析TCT检查结果和HPV感染情况,并对其中TCT检查结果为大于非典型鳞状细胞(ASC)的类型、HPV-DNA阳性的患者进行阴道镜病理检查,分别将TCT检查、HPV检查、联合检查的诊断结果与阴道镜病理检查结果进行比较,分析各检查方法对宫颈高危病变的诊断价值。结果本次2123名女性共检出HPV阳性386例,阳性率为18.18%,共检出高危型HPV阳性329例、占比85.23%,低危型HPV阳性98例、占比25.39%,其中41例同时检出高危与低危阳性,其中单一感染217例、占比56.21%,双重感染78例、占比20.20%,三重及以上感染91例、占比23.57%。TCT检查结果显示LSIL+HSIL+SCC+ACC有86例、占比4.05%,ASC 93例、占比4.38%。阴道镜病理活检结果显示CINⅠ级48例,CINⅡ级5例,CINⅢ级6例,腺癌+鳞癌2例。与病理检查结果比较,HPV检查符合率为73.77%(45/61);TCT检查符合率为60.66%(37/61);TCT联合HPV检查符合率为90.16%(55/61)。TCT联合HPV检查结果的符合率明显高于TCT与HPV单项检查的结果,差异有统计学意义(P<0.05)。结论TCT联合HPV检查能够有效降低对宫颈病变的漏诊率,具有较高临床应用及推广价值。Objective To study the clinical diagnostic value of thinprep cytology test(TCT)combined with human papilloma virus(HPV)examination in high risk cervical lesions,in order to provide reference scheme for the diagnosis of high risk cervical lesions.Methods A total of 2123 women who were examined by TCT and HPV-DNA from July 2021 to July 2022 in the department of gynecology in Tianjin Binhai New Area Hospital of Traditional Chinese Medicine were selected,TCT examination results and HPV infection condition were analyzed.And the patients whose TCT examination results were higher than those of atypical squamous cells(ASU)type and positive HPV-DNA were examined by colposcopy pathology.The examination results of TCT,HPV and joint examinations were compared with those of colposcopy pathology,and the diagnostic values of each examination method for high risk cervical lesions were analyzed.Results A total of 386 HPV positive cases were detected in 2123 women,with a positive rate of 18.18%.A total of 329 high risk HPV positive cases were detected,accounting for 85.23%;98 low risk HPV positive cases,accounting for 25.39%,of which 41 cases were detected with high risk and low risk positive cases at the same time,of which 217 cases were single infection,accounting for 56.21%,78 cases were double infection,accounting for 20.20%,and 91 cases were triple infection or more,accounting for23.57%.TCT examination results showed that 86 cases of LSIL+HSIL+SCC+ACC,accounting for 4.05%,and 93 cases of ASC,accounting for 4.38%.Pathological biopsy of colposcopy showed 48 cases of CINⅠ,5cases of CINⅡ,6 cases of CINⅢ,and 2 cases of adenocarcinoma+squamous cell carcinoma.Compared with pathological examination,the coincidence rate of HPV examination was 73.77%(45/61);the coincidence rate of TCT examination was 60.65%(37/61);the coincidence rate of TCT combined with HPV examination was 90.16%(55/61).The coincidence rate of TCT combined with HPV was significantly higher than that of TCT and HPV single examination,and the differences were sta

关 键 词：宫颈脱落细胞 人乳头瘤病毒 宫颈病变 筛查 

分 类 号：R44[医药卫生—诊断学]