液基细胞学联合高危人乳头瘤病毒检测对宫颈癌前病变的诊断价值

目的：探讨高危人乳头瘤病毒DNA（HPV DNA）检测联合液基细胞学技术（LCT）对宫颈癌癌前病变的诊断价值。方法：选取2008年1月—2010年3月收治的患者365例，分别进行LCT、高危HPV DNA筛查及组织病理学检测，以组织病理学诊断为金标准，比较2种筛查方法的准确性。结果：HPV阳性106例，其中病理检查结果阳性84例；LCT阳性≥意义不明的非典型鳞状上皮细胞（ASCUS）]178例，其中病理检查结果阳性的121例；HPV和LCT均为阴性的143例中病理活组织检查阳性2例。LCT诊断宫颈癌癌前病变的敏感度和特异度分别为80.1%和84.9%；HPV诊断宫颈癌癌前病变的敏感度和特异度分别为55.6%和74.1%。2种方法联合检测宫颈癌癌前病变（其中一项阳性即诊断为患者）的敏感度和特异度分别为98.7%和98.6%。结论：联合应用高危型HPV DNA检测与LCT方法可以增加宫颈癌癌前病变的检出率，可有效预防宫颈癌的发生发展。

Diagnostic Value of the Cervical Precance rous Lesions by Liquid-based Cytology Technique Combined with High-risk HPV-DNA Detection

Objective： To evaluate the diagnostic application of the high-risk human papilloma virus DNA （HPV-DNA） detection combined with liquid-based cytology technique （LCT） in cervical precancerous lesion. Methods：365 women with cervical precancerous lesion from Department of obstetrics and gynecology，Jiangsu Cancer Hospital，January 2008 to March 2010，were selected. The Screening of cervical cancer was performed by LCT and HPV-DNA detection. All women underwent colposcopic cervical biopsies and pathological examination. Pathological examination was regard as the gold standard to diagnosis cervical precancerous lesions. Results：The HPV positive results were observed in 106 cases and the LCT positive results （≥ASCUS） in 178 cases，the positive results of pathological examination were 84 and 121 cases，respectively. In 143 women with negative results of LCT and HPV detection，only two cases had the posotive results of pathological examination. The diagnostic sensitivity and specificity of LCT for cervical precancerous lesions were 80.1% and 84.9%. The diagnostic sensitivity and specificity of HPV were 55.6% and 74.1%. The sensitivity and specificity increased to 98.7% and 98.6% when combined two methods. Conclusions：Liquid-based cytology technique combined with high-risk HPV-DNA detection is better than any single technique for screening precancerous lesion of cervical carcinoma.