薄层液基细胞学检查联合人乳头瘤病毒检测在宫颈癌前病变筛查中的应用

目的探讨薄层液基细胞学检查(TCT)联合人乳头瘤病毒(HPV)检测在宫颈癌前病变筛查中的临床价值。方法对门诊1152例宫颈疾病患者进行TCT检查和HPV分型检测。182例TCT检查诊断为非典型鳞状上皮意义不明确(ASCUS)及以上或HPV阳性及临床症状高度疑似病例患者均在阴道镜下取病理活检。结果 1 152例受检者中,TCT阳性155例,占13.45%,HPV阳性143例,占12.41%,差异无统计学意义(P>0.05)。TCT检查异常者中ASCUS、LSIL、HSIL和SCC的HPV感染率分别为70.59%、82.98%、93.75%和100.00%。随着细胞学级别的增高,HPV检出率逐渐增高(P<0.05);随着病理级别的升高,HPV和TCT均为阳性的检出率也越来越高(P<0.05)。155例TCT阳性患者与阴道镜下病理组织活检结果比较显示,随着细胞学级别的增高,病理级别逐渐增高(P<0.05)。结论 TCT检查为一种准确、简便的宫颈病变的细胞学检查方法,结合HPV分型检测不失为一种先进的宫颈癌前病变和宫颈癌的筛查方法。

Application of thinprep cytologic test and human pappilomavirus testing in cervical precancerous lesion

Objective To evaluate the significance of thinprep cytologic test （TCT） and human papillomavirus {HPV} testing in screening cervical precancerous lesion. Methods A total of 1152 cases were examined for HPV and abnormal cervical smear, 182 of which received colposcopy with biopsy. Results Of the 1152 cases, the positive rate of TCT and HPV was 13.45% （155/1152 ） and 12.41% （ 143/1152 ）. No significant difference was found between them （ P 〉 0.05 ）. A total of 155 cases with abnormal cervical smear were examined for HPV ,with the HPV positive rate of ASCUS 70.59% { 60/85 }, LSIL 82. 98% （39/47}, HSIL 93.75% （15/16） ,and SCC 100.00% {7/7 }. With the rise in cytological level,so gradually increased the positive rate of HPV. And likewise, the rise of pathological grade was correlated with gradual rise of the positive rate of HPV and TCT. A total of 155 cases with abnormal cervical smear received colposcopy with biopsy, in which the rise of cellular level proceeded gradual rise of pathological grade. Conclusion TCT is the practical method for detecting cervical lesion . TCT combined with HPV testing is the optimal screening approach to cervical lesion .