TOT和HPV—DNA检测联合阴道镜对宫颈癌筛查的应用价值

目的：研究在宫颈癌临床筛查中采用薄层液基细胞学检查（TCT）、HPV—DNA检测联合阴道镜诊断的应用价值。方法：回顾性分析我院2007～2012年TCT、HPV—DNA检测筛查的1198例患者的临床资料，对TCT、HPV—DNA检测可疑的368例患者同时在阴道镜下进行宫颈活检、病理检测和TCT、HPV—DNA检测，比较检测结果。结果：TCT检测结果与HPV—DNA比较，正常和炎症患者的HPV检测阳性率和TCT检测低度鳞状上皮内病变（LSIL）、高度鳞状上皮内病变（HSIL）组有明显差异（P〈0．01），意义不明确的非典型鳞状细胞（ASCUs）组检测阳性率和HSIL组有明显差异（P〈0．01），TCT检测结果级别分类越高，HPV检测阳性率越高。病理学诊断与TCT、HPV—HPV检测结果比较，重度不典型增生（CINⅢ）组和鳞状细胞癌（SCC）组与其他两组具有明显差异（P〈0．01），TCT、HPV同时检测阳性率高，全部患者通过单一或者协同检测能达到无漏检，但是中度不典型增生（CINⅡ）、轻度不典型增生（CINⅠ）组有漏检的情况发生。结论：子宫内膜癌临床筛查中采用TCT、HPV—DNA检测联合阴道镜诊断，可提高诊断准确率，为临床手术治疗宫颈癌提供诊断依据，值得临床推广。

Application of combination detect of TCT,HPV-DNA and colposcope in screening of cervica cancer

Objective; To explore application of combination detect of TCT, HPV-DNA and colpo- scope in screening of cervical cancer. Methods： Clinical data of 1 198 cases with TCT and HPV-DNA admitted from 2007 2012 were retrospectively analyzed. And 368 suspicious cases received cervical biopsy, pathological examination, TCT and HPV-DNA under colposcope. The results were compared. Results： There was significant difference in positive rate between normal and inflammatory patients detected by HPV and LSIL, HSIL patients detected by TCT （P〈0.05）. And the difference in positive rate was also significant between ASCUS and HSIL （P（0.01）. The higher the type of TCT was, the higher HPV positive rate was. Positive rate of CINⅢ and SCC group was significantly different from other two groups（P〈0.01）. The positive rate of patients with TCT and HPV was highest. There was missed diagnosis in CIN Ⅱ and CIN Ⅰ group. Oonclusions. Combination detection of TCT, HPV-DNA and colposcope in screening of cervical caner can increase accuracy. It can provide evidence for diagnosis, and is worthy clinical application.