HPV-DNA 和TCT 检测在宫颈癌前病变筛查中的诊断价值

目的:探讨乳头瘤病毒定性检测( HPV- DNA)与液基薄层细胞学检查技术(TCT)在宫颈癌前病变中的诊断价值.方法:分别采用HPV- DNA及TCT法检测1536例患者,对TCT阳性、HPV- DNA阳性病例者进行阴道镜下活检.结果:随着病理诊断级别的升高,高危型HPV感染率上升,而低危型HPV感染多见于轻度不典型增生(CINⅠ)及其以下病变,HPV混合感染在各组间未见明显趋势.HPV-DNA检测与宫颈活检的符合率为66.78％.随着病理级别的升高,不典型鳞状细胞(ASCUS)组的感染率呈降低趋势,鳞状上皮内低度病变(LSIL)组感染率亦呈下降趋势,而鳞状上皮内高度病变(HSIL)组和鳞癌(SCC)组感染率均呈上升趋势,TCT检测与组织学诊断的符合率为66.67％,与HPV-DNA检查比较,差异无统计学意义(x=0.001,P＞0.05).结论:HPV-DNA、TCT及宫颈活检三者检测相结合,能明显提高诊断的正确性.

Diagnostic Value of HPV-DNA and TCT Test in Screening of Cervical Lesions

Objective: To study the clinical application value of the qualitative detection of human papillomavirus(HPV-DNA) and ThinPrep cytology technique(TCT) in prevention of cervical lesions and cervical cancer.Methods: Totally 1536 cases were screened by HPV-DNA test or TCT test.Directed biopsies under colposcopy were taken either in both positive test.Results: The pathological diagnosis level rose when high-risk HPV infection increased,while low-risk HPV infection was appeared more commonly in CIN I lesions,but HPV co-infection had no significant trend in each group.The compliance rate of HPV-DNA testing with the histological diagnosis was 66.78%.With the increased pathological grade,ASCUS group infection rate was decreasing,and LSIL group infection rate was also found a downward trend,while the prevalence of HSIL group and SCC group were rising.The compliance rate of TCT test with the histological diagnosis was 66.67 %,and there was no significantly difference between HPV-DNA test and TCT test(X2 = 0.001,P> 0.05).Conclusion: The combination of HPV-DNA,TCT test and cervical biopsy can significantly improved diagnostic accuracy.