高危型HPV与TCT联合筛查时CIN病变漏诊情况分析  

Misdiagnosis of High-risk HPV Combined with TCT in Screening CIN

作　　者：童永平[1] 

机构地区：[1]四川省什邡市人民医院,618400

出　　处：《实用癌症杂志》2015年第4期575-576,579,共3页The Practical Journal of Cancer

摘　　要：目的探讨高危型HPV与TCT联合筛查时CIN病变漏诊情况。方法收集高危型HPV阳性、TCT阴性并有宫颈活检或LEEP刀手术切除标本433例,并与同期高危型HPV及TCT均阴性并有宫颈LEEP刀手术切除标本618例比较,分析各自CIN病例数。结果 HPV(+)组确诊有CINⅠ6例,CINⅡ3例,CINⅢ2例,检出率2.54%;HPV(-)组有CINⅠ1例,CINⅡ1例,检出率0.32%;两者比较,差异有统计学意义(P<0.005)。同时,HPV(+)组高级别CIN检出率较高,两者比较,差异有统计学意义(P<0.05)。说明虽然TCT为阴性,但HPV(+)组CIN检出率明显高于HPV(-)组,HPV(+)组CIN漏诊率及高级别CIN漏诊率均较高。结论对HPV(+)和TCT(-)病例,应积极采取措施,避免漏诊病例发展为严重病变。Objective To study the misdiagnosis of high-risk HPV combined with thinprep cytologic test(TCT) in screening cervical intraepithelial neoplasia(CIN).Methods 433 cases of high-disk HPV-positive,TCT-negative and cervical biopsy or LEEP operation,and 618 cases of high-risk HPV-negative,TCT-negative and cervical biopsy or LEEP operation were compared,their respective CIN cases were analyzed.Results In the HPV-positive group,6 cases were confirmed to be CIN Ⅰ,3 cases were confirmed to be CIN Ⅱ,2 cases were confirmed to be CIN Ⅲ,the total detection rate was 2.54%.In the HPV-negative group,1 case were CIN Ⅰ,1 case were CIN Ⅱ,the detection rate was 0.32%.There was statistically significant difference between the 2 groups(P < 0.005).Meanwhile,the detection rate of high grade CIN in HPV-positive group was higher than that of HPV-negative group,there was statistically significant difference between the 2 groups(P < 0.05).Although TCT was negative,the detection rate in HPV-positive group was higher than that of HPV-negative group,misdiagnosis rates of CIN and high grade CIN were higher.Conclusion To the high-risk HPV-negative and TCT-negative cases,positive measures should be taken to avoid misdiagnosis cases developing into severe lesions.

关 键 词：高危型HPV TCT 漏诊 LEEP 宫颈上皮内瘤变(CIN) 

分 类 号：R737.33[医药卫生—肿瘤]