细胞学联合HPV检测在宫颈病变筛查中的应用

目的:评价细胞学联合HR-HPV检测对宫颈病变筛查的效力。方法:对173例细胞学异常(TBS系统≥ASC-US)的患者同时用HC-Ⅱ(Hybrid CaptureⅡ)方法检测高危型HPV(HR-HPV)阳性,并与仅行细胞学检查的149例患者进行比较,以病理学为金标准,比较两种方法在宫颈病变筛查中的意义。结果:在173例细胞学≥ASC且HPV阳性者中,病理学为NILM39例,占22.5%;病理学≥LSIL/HPV139例,占80.3%,而单纯细胞学≥ASC共149例,病理学为NILM48例,占32.2%;≥LSIL101例,占67.8%。经统计学处理,HPV+细胞学检查与单纯细胞学异常比较,对低度宫颈病变(病理学≥CINⅠ/HPV)前者的敏感性、特异性均高于后者;对高度宫颈病变(CIN≥Ⅱ/Ⅲ),HPV+细胞学检查与单纯细胞学异常比较,敏感性无显著性差异,而特异性低于后者。结论:细胞学、HPV检测是有效的宫颈低度病变筛查方法,二者联合应用更有利于科学地管理宫颈病变。

Application of cytology and high risk-human pappilomavirus testing in cervical lesion

Objective:To evaluate the significance of cytology and high risk-human pappilomavirus(HR-HPV) testing in screening cervical lesion.Methods:A total of 173 cases with abnormal cervical smear were examined for HR-HPV by hybrid capture Ⅱ,149 cases were examined for only cervical smear,then all of them received colposcopy with biopsy.Results:In the 173 cases of the positive of HR-HPV and cytology ≥ASC,NILM was 22.5%(39/173),LSIL 80.3%(139/173).In the 149 cases of cytology ≥ASC,NILM was 32.2%(48/173),LSIL67.8%(101/173).For the detection of cervical intraepithelial neoplasia(>CINI/HPV),the sensitivity of cytology combined with HR-HPV were higher than cytology.Significant differences among the two methods were observed.For the detection of high-grade cervical intraepithelial neoplasia(≥CI N II/IIl),the sensitivity of cytology and cytology combined with HR-HPV had no significant difference with cytology.Significant difference among the two methods was found in specificity,but not in sensitivity(P>0.05).Conclusion:Cytology and HR-HPV testing are the practical methods for detecting cervical lesion.Cytology combined with HR-HPV testing is the optimal screening approach of cervical lesion.