高危型HPV筛查与TCT 联合检查在宫颈癌筛查中的临床应用

目的:探究液基薄层细胞学检测(TCT)与高危人乳头瘤病毒(HR-HPV)筛查联合检查在宫颈癌(CC)筛查中的临床价值。方法:选择2013年4月~2015年4月期间我院就诊疑似CC患者318例为研究对象;研究对象均进行HR-HPV筛查、TCT检查及阴道镜下病理活检,评价三种筛查结果的临床应用价值。结果:318例可疑CC患者中,病理学诊断炎症患者162例(50.94%),宫颈上皮内瘤样变(CIN)患者151例(47.48%),鳞癌(SCC)患者5例(1.57%);HR-HPV、TCT及HPV+TCT联合对诊断结果与病理诊断的符合率分别为78.30%、85.22%和99.37%;HR-HPV与TCT单独检测的符合率随患者病情进展呈现升高趋势(P0.05);TCT、HR-HPV检测单独进行诊断的敏感度、特异度均低于联合诊断(P0.05);HR-HPV与TCT联合检测诊断CC的敏感度为98.71%、特异度100%。结论:TCT检查HR-HPV筛查联合检查CC的敏感性、特异性及准确性高,为CC筛查的有效方式,值得在临床应用推广。

Clinical Application of HR-HPV Combined with TCT in Screening of Cervical Cancer

Objective:To explore the clinical application value of high risk-human papilloma virus (HR-HPV) combined with thin cytologic test (TCT) in screening of patients with cervical cancer (CC).Methods:A total of 318 patients with suspected CC, who were treated in Wuhan Commercial Staff Hospital from April 2013 to April 2015, were chosen as research subjects. All the subjects were given HR-HPV, TCT screening,and pathologic biopsy under vaginoscopy. The clinical application value of the three screening methods was evaluated.Results:The pathological results showed that there were 162 patients with inflammation (50.94%), 151 patients with cervical intraepithelial neoplasia (CIN)(47.48%) and 5 patients with squamous cell carcinomas (SCC)(1.57%) among the 318 suspected patients. The coincidence rate of HR-HPV, TCT and HPV+TCT and pathological results were 78.30%, 85.22%and 99.37%respectively. The coincidence rate of HR-HPV and TCT screening were increased with the severity of disease (P<0.05).The sensitivity (98.71%) and specificity (100%) of HPV+TCT were significantly higher than TCT, HR-HPV screening separately (P<0.05).Conclusion:HR-HPV combined with TCT screening has high sensitivity, specificity and accuracy in the screening of patients with CC, which is an effective way for CC screening and worth popularizing in clinical application.