液基细胞学联合高危型人乳头瘤病毒检测对宫颈病变诊断的意义

目的探讨宫颈液基细胞学(thin-prep cell test,TCT)联合高危型人乳头瘤病毒(human papilloma virus,HR-HPV)检测对宫颈病变诊断的意义。方法选取2010年3月—2011年10月就诊的妇女1 575名,随机均分为TCT组、HPV组、联合组,分别进行高危型HPV、TCT及HPV联合TCT检查,检查结果呈阳性的患者行阴道镜下多点活检病理学检查。比较三种检查方法阳性病例与病理检查结果的符合率。结果阳性符合率TCT组30.43%,HPV组31.90%,联合组97.54%,联合组明显高于HPV组与TCT组(均P<0.05)。在不同宫颈病变中高危型HPV的阳性率分别为宫颈上皮内瘤变(cervical intraepithelical neoplasia,CIN)Ⅰ18.00%、CINⅡ42.86%、CINⅢ49.12%、鳞状细胞癌(squamous cell carcinoma,SCC)75.00%。结论高危型HPV感染与宫颈病变严重程度密切相关,宫颈病变严重度越高,HPV感染的阳性率越高。高危型HPV检测联合TCT检查可提高宫颈病变检出率,为宫颈癌的早期诊断提供参考。

Significance of thin-prep cell test combined with detection of high-risk humanpapillomavirus in the diagnosis of cervical lesions

Objective To investigate the significance of thin-prep cell test（TCT） combined with detection ofhigh-risk human papillomavirus indiagnosingcervical lesions. Methods1575 medically treated women were selected from March 2010 through October2011and randomly divided into three groups： TCT group,HPV group and combined group,which receivedTCT,HR-HPV,and TCT combined with HR-HPVrespectively.Patients with positive results received colposcopic examination for multi-point pathological biopsy,and the three groups were compared for the rate that the positive cases detected by the three methods were in accordance with pathological results. ResultsThe positive coincident rate was31.90%,30.43% and 97.53% in HPV group,TCT group and combined group respectively.It was significantly higher in the combined group（P〈0.05）.The positive rate of high-risk HPV infection in different cervical lesions was 18.0% in CINⅠ（cervical intraepithelical neoplasia）,42.86% in CINⅡ,49.12% in CINⅢ,and75.0% in SCC（squamous cell carcinoma）. Conclusions The infection of high-riskHPV is closely related to the severity of cervical lesions.The positive rate of HPVinfectionincreases significantly with the severityof cervical lesions.Examination ofhigh-risk human papillomaviruscombined with TCT can improve the detection rate of cervicallesions,which provides a reference for early diagnosis of cervical cancer.