TCT联合HPV-DNA及端粒酶检测在宫颈癌前病变筛查中的应用

目的研究液基薄层细胞学(TCT)联合高危型人乳头瘤病毒DNA(HPV-DNA)、端粒酶在宫颈癌前病变检测中的临床应用价值。方法对宫颈不同病变,包括慢性宫颈炎55例,宫颈上皮内瘤变(CIN)Ⅰ62例、CINⅡ112例、CINⅢ41例,同时进行TCT、HPV-DNA、端粒酶的检测,并对3项结果进行比较。结果 TCT单独检查CIN阳性率为64.6%,其中CINⅡ~Ⅲ诊断阳性率为77.8%;HPV-DNA诊断CINⅡ~Ⅲ的阳性率为96.7%,高于该组TCT的阳性率(77.8%),差异有统计学意义(P0.05);CIN端粒酶阳性表达率高于慢性宫颈炎(P0.05);3项指标联合检测的灵敏度为94.0%,特异度为100.0%,阴性预测值为80.9%,阴性预测值明显高于其他2项联合检测。结论 TCT联合HPV-DNA及端粒酶检测相互可以提高检出率,对于宫颈癌前期病变的早期诊断、疾病评估、治疗及预后具有较高的临床价值。

Application of TCT combined with HPV-DNA and telomerase detection in screening cervical precancerous lesions

Objective To investigate the clinical application value of thinprep cytological testing (TCT ) com-bined with high-risk type human papilloma virus (HPV) DNA and telomerase detection in cervical precancerous le-sions .Methods The patients with different cervical lesions ,including 55 cases of chronic cervicitis ,62 cases of intra-epithelial neoplasia (CIN)Ⅰ ,112 cases of CINⅡ and 41 cases of CIN Ⅲ ,were simultaneously detected TCT ,HPV-DNA and telomerase .The detection results were compared .Results The positive rate of CIN detected by single TCT was 64 .6% ,in which the diagnostic positive rate of CIN Ⅱ - Ⅲ was 77 .8% ,the positive rate of HPV-DNA for diag-nosing CIN Ⅱ - Ⅲ was 96 .7% ,which was higher than 77 .8% of TCT in this group ,the difference was statistically significant (P<0 .05);the positive expression of telomerase in CIN was significantly higher than that in chronic cer-vicitis (P<0 .05);the sensitivity in the combined detection of TCT ,HPV and telomerase was 94 .0% ,the specificity was 100 .0% ,the negative prediction value was 80 .9% ,the negative prediction value was significantly higher than that in the combined detection of other two items .Conclusion TCT combined with HPV-DNA and telomerase detec-tion can increase the detection rate of cervical diseases and has a higher clinical application value for the early diagno-sis of cervical precancerous lesions ,disease evaluation ,treatment and prognosis .