宫颈液基薄层细胞检测在宫颈癌筛查中的应用

目的 对宫颈液基薄层细胞检测（TCT）在宫颈癌筛查中的应用价值进行分析.方法 选取846例接受子宫颈病变筛查的成年女性作为研究对象.采用TCT、人乳头瘤病毒（HPV）检查及阴道镜检查,然后对TCT检查在宫颈癌筛查中的应用价值进行分析.结果 （1）本研究对846例接受子宫颈病变筛查的妇女进行检查发现,正常范围（WNL）组有144例HPV阳性,阳性率为20.1%（144/689）;意义不明确的非典型鳞状细胞（ASCUS）组有29例HPV阳性,阳性率为39.2%（29/74）;低度鳞状上皮内病变（LSIL）组有31例HPV阳性,阳性率为72.1%（31/43）;高度鳞状上皮内病变（HSIL）组有30例HPV阳性,阳性率为85.7%（30/35）;鳞状细胞癌（SCC）组有5例HPV阳性,阳性率为100.0%（5/5）.HPV感染率随着TCT检查结果诊断级别的升高而增高（χ^2=3.483 5,P＜0.05）.（2）对组织病理学及TCT、HPV检测结果进行比较发现,病理结果为宫颈上皮内瘤样变（CIN）Ⅰ级及以下患者有154例为HPV及TCT双阳性,病理结果为CINⅡ级患者有25例为HPV及TCT双阳性,病理结果为CINⅢ级患者有16例为HPV及TCT双阳性,病理结果为SCC患者有5例为HPV及TCT双阳性,病理结果为CINⅢ级及以上患者中,其多为HPV及TCT双阳性,无1例患者为HPV及TCT双阴性,CIN三组间比较差异具有统计学意义（χ2=3.647 4,P＜0.05）.结论 TCT检查联合HPV检查可以作为宫颈癌筛查的常规筛查方法,在临床上具有极大的应用价值.

Application of TCT examination in cervical cancer screening

Objective To investigate the clinical value of TCT examination in cervical cancer screening. Methods 846 adult women who received cervical cancer screening were chosen as research subjects. TCT examination, HPV examination and colposcopy were used to examine. Then, the clinical value of TCT examination in the cervical cancer screening was analyzed. Results （ 1 ） In this study, of 846 cases received cervical disease screening, WAL group had 144 patients with HPV-positive, the positive rate was 20.1% （ 144/689 ） ;29 patients in ASCUS group were HPV-positive,the positive rate was 39.2% （29/74） ;31 patients in LSIL group were HPV-positive, the positive rate was 72.1% （31/43 ） ;30 patients in HSIL group were HPV-positive, the positive rate was 85.7% （30/35） ;5 patients in SCC group were HPV-positive, the positive rate was 100% （5/5）. HPV infection rate was gradually increased with the increased grade of TCT results （ X^2 = 3. 483 5,P 〈 0.05 ）. （2） The resuhs of histopathology and TCT, HPV test were compared, the results showed that, 154 patients were HPV and TCT double positive in patients pathologically diagnosed less than CIN I ,25 patients were HPV and TCT double positive in patients pathologically diagnosed CIN Ⅱ , 16 patients were HPV and TCT double posiiive in patients pathologically diagnosed CIN Ⅲ ,5 patients were HPV and TCT double positive in patients pathologically diagnosed SCC. Most of the patients were HPV and TCT double positive in patients pathologically diagnosed more than CIN m, and no patient was HPV and TCT negative, the differ- ence was significant （ X^2 = 3. 647 4, P 〈 0.05）. Conclusion TCT examination combined with HPV test can used as routine screening method of cervical cancer in clinical application.