TCT和高危型HPV在宫颈病变筛查中的联系和价值

目的 研究薄层液基细胞学（TCT）和高危型HPV在宫颈病变筛查中的联系和价值. 方法 收集2012年5-7月在湖南省妇幼保健院进行宫颈液基细胞学检查同时做了HC2-HPV DNA检测的患者451例,对于其中任一检测结果为阳性的病例或临床症状疑似的患者做阴道镜检查,对其结果进行分析和比较,从而了解两者的联系及应用价值.结果 451例受检者中,TCT结果异常的有254例占56.3％.ASCUS 96例,LSIL 75例,HSIL 57例,SCC 26例,分别占21.2％、16.6％、12.6％、5.7％.254例细胞学异常的受检者中高危型HPV阳性率68.1％,其中ASCUS、LSIL、HSIL、SCC高危型HPV阳性率分别为42.7％ （41/96）、76.0％ （57/75）、85.9％ （49/57）、100％ （26/26）.显示随着宫颈病变程度地增加,HPV的感染率也相应增高. 结论 TCT联合HPV检测更能有效的发现和诊断宫颈癌及癌前病变,提高诊断的准确率,降低漏诊率,为临床防治宫颈病变提供更加可靠的科学依据,是目前最好的筛查方案.

Relation and Value of ThinPrep Cytological Test and High Risk Hybrid Capture 2 Human Papilllmavirus DNA Test in Cervical Lesions Screening

Objective To study the relation and value of ThinPrep cytological test （TCI＇） and high risk hybrid capture 2 human papillomavirus （HC2 - HPV） DNA test in screening of cervical lesions. Methods Four hundred and fifty - one pa- tients who simultaneously underwent ThinPrep cytology test and HC＇2 - HPV DNA test in Hunan Provincial Maternal and Child Health Hospital from May to July 2012 were enrolled in this study. Colposeopy examination was conducted in the patients with one positive result of the above-mentioned tests or with suspected clinical symptoms, and the colposeopic diagnosis results were compared and analyzed so as to explore the relation and application value of TCT and HC2 - HPV DNA test. Results Among 451 patients, 254 （56.3%） had an abnormal result of TCT. AS（US, LSIL, HSIL and FCA2 were seen in 96 （21.2%）, 75 （16.6%）, 57 （12.6%）, and 26 （5.7%） patients, respectively. Among 254 women with abnormal TCT result, the positive rate of high risk HPV was 68.1%. The high risk HPV positive rates of AS（US, LSIL, HSIL, and SCC were 42.7% （41/96）,76.0% （57/75）, 85.9% （49/57） and 100% （26/26）, respectively. It showed that with the increase of cervical lesions degree, HPV infection rate also increased accordingly. Conclusions The results suggest that TCT combined with HC2 - HPV DNA test is an effective method in detection and diagnosis of cervical cancer and precancerous lesions, which improves the accuracy rate of diagnosis and reduces the omission diagnostic rate. It is the best cervical screening test at present and provides a more reliable scientific basis for prevention and treatment of cervical lesions.