HPV-DNA分型检测联合液基细胞学对宫颈癌筛查的意义及临床价值的研究

目的研究HPV-DNA分型检测联合宫颈液基细胞学检查（TCT）对宫颈癌筛查的意义及临床价值。方法将于我院就诊的564例妇女同时行TCT、PCR荧光检测HPV-DNA和宫颈活检组织学检查,采用膜杂交法检测23个HPV基因型别（低危型：HPV6、11、42、43、45和高危型：HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83、MM4）和液基细胞学（TCT）作为宫颈癌和癌前病变的筛查。比较TCT对宫颈细胞异常的检出率以及TCT检测联合PCR荧光检测HPV-DNA对HPV感染的检出率,以病理学诊断为标准。结果 PCR荧光法检测HPV-DNA总检出率为21.0%,组织学阳性病例检出率70.9%,组织学阴性病例检出率4.5%,均显著高于TCT,呈极其显著性差异,P〈0.01。其中单一型HPV感染中,低危型占34%、高危型占60%、二型和二型以上混合感染占6%。结论 HPV基因分型检测是有价值的辅助诊断技术,与细胞学联合,是最佳的宫颈癌筛查的方案,能明显提高诊断的准确性和早发现癌前病变。

HPV-DNA Parting Joint Fluid Cytology for Detection Base Cervical Cancer Screening the Significance and the Clinical Value of Research

Objective detection of HPV-DNA typing of liquid-based cervical cytology combined （TCT） on the significance of cervical cancer screening and clinical value.Methods will be our hospital 564 cases of women simultaneously TCT,PCR fluorescent detection of cervical HPV-DNA and biopsy examination,was detected by membrane hybridization HPV genotypes 23 （low risk type：HPV6、11、42、43、45、and high-risk types：HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83、MM4） and liquid-based cytology （TCT）As screening for cervical cancer and precancerous lesions.Comparison of TCT on the detection rate of abnormal cervical cells and the TCT joint PCR detection of HPV-DNA fluorescence detection rate of HPV infection,the pathological diagnosis as the gold standard. Results PCR detection of HPV-DNA fluorescence total detection rate of 21.0%,histology-positive case detection rate of 70.9%, case detection rate of histologically negative 4.5%,respectively,significantly higher than the TCT,was very significant difference, P0.01.One single type HPV infection, accounting for 34% of low risk, high risk 60%,and type II mixed infections accounted for more than 6%.Conclusions HPV genotyping is a valuable adjunct to diagnostic techniques,combined with cytology,is the best cervical cancer screening program can significantly improve the diagnostic accuracy and early detection of precancerous lesions.