TCT联合HPV检测在宫颈病变筛查中的意义

目的探讨宫颈液基细胞学检查与人乳头状瘤病毒检测联合应用在宫颈病变筛查中的意义。方法选取2010年3月-2011年12月孝感市中心医院病理科同时进行了宫颈液基细胞学(TCT)检查及人乳头状瘤病毒(HPV)检测的患者3028人,TCT采用2001年国际癌症协会TBS诊断系统报告方式,对TCT检查结果为ASCUS及以上病变和(或)HPV检测结果为阳性的患者在电子阴道镜下取宫颈组织活检。结果 TCT检查敏感度为56.72%,特异度为28.19%;HPV检查敏感度为86.03%,特异度为46.38%;病理结果为CIN及宫颈癌的408例中单一TCT阳性28例,占6.86%;TCT与HPV同时阳性203例,占49.75%,单一TCT检查与TCT联合HPV检查方法两者在病检结果为宫颈鳞状上皮内肿瘤(CIN)及宫颈癌中差异有统计学意义(χ2=184.926,P=0.000)。结论 TCT联合HPV检查可以提高宫颈癌及其癌前病变的检出率,提高筛查的敏感性和特异性,有效降低了TCT检测中的假阴性率,避免了低风险人群的过度阴道镜活检及过度治疗。

Cervical Liquid-Based Cytology Combined Human Papillomavirus Testing in Cervical Lesion

Objective To study the significance of combination of cervical liquid-based cytology and human papillomavirus detection in cervical lesion screening.Methods From March 2010 to December 2011,3,028 patients were detected with nipple shaped tumor virus(HPV) and cervical liquid base cytology(TCT),TCT was used by 2001 International Cancer Association TBS diagnosis system report way,to the patients with positive results of TCT check for ASCUS and the above lesions and(or) HPV detection,cervical organization biopsy under electronic vaginal mirror were performed.Results The sensitivity of TCT check was 56.72%,with the specificity of 28.19%;the sensitivity of HPV check was 86.03%,with specific for 46.38%;among 408 cases of CIN and cervical cancer pathology,28 cases were single TCT positive(6.86%);with TCT and HPV positive 203 cases(49.75%),there was significant difference in diagnosis of cervical squamous intraepithelial neoplasm(CIN) and cervical cancer(χ2=184.926,P=0.000) between single TCT check and combination of TCT and HPV examination.Conclusion TCT combined with HPV check can improve the detection rate of cervical cancer and precancerous lesions,improve the sensitivity and specificity of screening,effectively reduce the TCT in detection of false-negative rates,and avoid excessive colposcopy and biopsy in low-risk populations and over-treatment.