宫颈 TCT 异常患者行 HPV 检测在宫颈病变诊断中的临床价值

目的：探讨薄层液基细胞学检查（TCT）异常的患者行人乳头状瘤病毒（HPV）检测在宫颈癌及癌前病变诊断中的临床价值。方法：2010年3月至2012年3月在汉川市人民医院妇科门诊就诊的患者共计2389例行液基细胞学检查，结果异常的有526例患者，同时进行HPVDNA检测和阴道镜下宫颈活检，以组织病理学结果作为诊断的金标准。结果：宫颈活检组织病理学诊断结果：526例患者中宫颈炎及CINI456例，占86．69％，CINIl34例，占6．46％，CINⅢ32例，占6．08％，宫颈浸润癌4例，占0．76％。HPVDNA检测阳性者共有226例，阳性率随病变严重程度的增加而增加。CINII级及其以上病变检出率在HPVDNA检测阳性组中明显高于阴性组中，两组比较有显著性差异（P〈0．05）。结论：细胞学检查结果异常的患者，病理组织学检查结果相差较大，可以从宫颈炎症到宫颈癌。HPVDNA检测可以减少单纯应用薄层液基细胞学而造成的宫颈病变漏诊率，并对细胞学结果有进一步的分流作用。

Clinical value of HPV testing in women with atypical squamous cells of cervical lesions

Objective： To analyze the clinical value of HPV testing for the diagnosis of cervical cancer and precan- cerous lesions in women with abnormal liquid - based cytology. Methods ： A retrospective study was carried out on pa- tients whose liquid - based cytology were abnormal in 526 cases all subjects were examined by HPV DNA testing and Colposcopy - directed biopsy. Results： In 526 cases patients with abnormal TCT, cervicitis and CIN I was 456 cases, accounting for 86.69% , CIN was 34 cases,accounting for 6.46% ,32 cases of CIN Ill ,6.08% , cervical carcinoma was 4 cases,accounting for 0.76%. 226 cases was HPV positive, the positive rate was increased with the severity of disease. CIN 1] level and above lesion detection rate was significantly higher in HPV positive group than that of nega- tive group in HPV detection, there were significant differences between two groups （ P 〈 O. 05 ）. Conclusion ： Patients with abnormal cytology results could be with different histopathologieal results, from cervicitis to cervical cancer. HPV - DNA detection can reduce the rate of misdiagnosis in simple application of liquid - based cytology on cervical le- sions, and there was further Shunt function for cytology results.