宫颈液基细胞学检查9260例结果分析

目的 探讨液基薄层细胞学检查术(TCT)和HPV-DNA杂交捕获检测在宫颈病变筛查中的作用.方法 对9260例门诊就诊患者进行TCT检查,840例TCT检查同时行HPV-DNA杂交捕获检测;836例细胞学阳性者行阴道镜检查下活检并送组织病理学检查,以组织病理学为标准,细胞学与之相对照.结果 在9260例TCT检测中细胞学阴性8374例,细胞学异常836例,细胞学阳性率为9.03％,ASC-US 398例(4.29％),LSIL 239例(2.58％),HSIL 179例(1.93％),SGUS 9例(0.097％),SCC 11例(0.12％).细胞学阳性30 ～40岁组比例最高,为43.66％,其次是40～50岁27.39％,＜30岁22.85％,50～60岁占5.14％,＞60岁占0.96％.各年龄组差异有统计学意义(P ＜0.01);HPV人群感染率为27.98％ (235/840),其中ASC-US中HPV阳性宫颈病变检出率81.58％ (31/38),而阴性8.98％( 15/167),二者之间差异有统计学意义(P＜0.01),LSIL中HPV阳性宫颈病变检出率95.45％％(21/22),HSIL中HPV阳性宫颈病变检出率100％(16/16),不同年龄段HPV感染率不同,各年龄组之间HPV感染率差异均具有统计学意义(x2 =25.2,P＜0.01);836例细胞学阳性经阴道镜下活检病理诊断,CIN及以上病例共507例,检出率为60.65％( 507/836),LSIL、HSIL、SCC的细胞学与病理诊断符合率分别为50.46％( 123/239),82.12％ (147/179),100.00％( 11/11),比较它们各自的符合率,差异有统计学意义(P＜0.01).结论 宫颈病变集中在性活跃期,以30 ～40岁为高峰,TCT筛查是诊断宫颈病变的重要方法,联合HPV-DNA杂交捕获检测,配合阴道镜下活检组织病理学检查,能提高子宫颈癌前病变和宫颈癌的检出率和准确率.

Analysis of 9260 cases of cervical cytology liquid-based thin-layer analysis

Objective To explore the role of thinprep cytology test（TCT）and HPV-DNA hybrid capture detection played in the screening of cervical lesions.Methods Do TCT examination on 9260 outpatients and do HPV-DNA hybrid capture detection on 840 cases therein,836 positive cases continued to have biopsy by colposcope,conformed to the gold standard of histopathology and contrast with cytology in the meantime.Results 8374 cases were negative in the TCT examination;836 cases were cytological abnormal.Cytology-positive rate was 9.03%,ASC-US 398 were 4.29%,LSIL 239 were 2.58%,HSIL 179 are 1.93%,SGUS 9 are 0.097%,SCC 11 are 0.12%.The group of＆nbsp; 30~40 ranked the highest in cytological positive,it′s 43.66%,the second highest was the group of 40 to 50,it′s 27.39%.The results of other groups were as follow：〈30 is 2.85%,50~60 is 5.14%,〉61 is 0.96%The difference of them was significant （P＜0.01）.HPV infection rate was 27.98%（235/840）.In ASC-US,the detectable rate of CIN in the HPV-positive group was 81.58%（31/38）,the HPV-negative group was 8.98%（15/167）,there was significant differene between the two methods（P＜0.01）.In LSIL,the detectable rate of CIN in the HPV-positive group was 95.45%（21/22）.In HSIL,the detectable rate of CIN in the HPV-positive group was 100%（16/16）.The infection rate in different age group is different,the difference was significant（χ2=25.2 P＜0.01）;836 positive cases had biopsy by colposcope,507 cases were diagnosed to be CIN,the detectable rate was 60.65%（507/836）.To organize pathology as control,the diagnose accordance rate of cytology and pathology of LSIL and HSIL and SCC were 50.46%,82.12%,100% （P＜0.01）.Took their accordance rate into comparison,the differene was significant.Conclusion Cervical lesion was collected in sex activity period,the peak was 31-40 years.TCT is propitious to screen cervical cancer and precancerous lesion,combined with HPV-DNA hybrid capture detection,colposcopy and pathology,can improve the diagnostic accuracy and the detective rate of CIN and cervical cancer.