宫颈刮片、阴道镜及HPV检测在诊断宫颈癌和癌前病变中的应用

目的:评价宫颈刮片、阴道镜及高危HPV检测在宫颈癌及癌前病变诊断中的效果。方法:对发现宫颈异常的患者同时进行宫颈刮片、阴道镜检查及高危HPV检测,对一项或多项异常者行病理组织学检查,并以病理结果为金标准。对134例病理结果阳性(CIN Ⅰ、CINⅡ、CINⅢ、宫颈浸润癌)的患者,比较三种方法的检出敏感度。结果:宫颈刮片阳性者70例,敏感度为52.2%,阴道镜108例,敏感度为80.6%,两者阳性检出率相比有极显著差异(P<0.01)。高危HPV感染者阳性118例, 敏感度88.1%,与宫颈刮片的敏感度相比有极显著差异(P<0.01),与阴道镜的敏感度相比,有显著差异(P<0.05)结论:对于宫颈癌及其癌前病变的筛查及早期诊断,应以宫颈细胞学检查和阴道镜检查及高危HPV检测相互结合以提高检出率,降低假阴性。

the Practical Use of PAP Smear,Colposcopy and HPV Test in the Diagnosis of Cervical Cancer and Precancerous Lesions

Objective:To evaluate the effect of PAP smear,colposcopy and high risk HPV test to diagnose of cervical cancer and prccancerous lesions. Methods: Patients with abnormal cervical lesions were detected by PAP smear, colposcopy and high risk HPV test simultaneously, 134 abnormal cases were diagnosed with pathologically, sensitivity of the were compared three methods. Results: 70 cases were positive in PAP smear, whose sensitivity was 52. 2% , whereas 108 cases were positive in colposcopy, whose sensitivity was 80. 6%,the difference of sensitivity was significant (P< 0. 01 ). HPV was positive in MS eases,the sensitivity was 88.1 %,the difference between PAP smear and HPV test was signiflcant(P<0. 01 ) and the difference between HPV test and colposcopy was also significant (P<0. 05). Conclusion: The combination of cytology, colposcopy and high risk HPV test can improve detective rate and accuracy and the difference between HPV test and colposcopy was also significant,can decreae false negative rate.