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目的探讨薄层液基细胞学检查(TCT)、高危型人乳头瘤病毒DNA(HPV-DNA)检测联合宫颈脱落细胞p16蛋白免疫组织化学检测在宫颈癌早期筛查中的价值。方法以该院于2014年6月-2016年12月采用TCT和HPV-DNA联合检测至少一项检查异常者900例为研究对象,对剩余细胞学标本进行宫颈脱落细胞p16蛋白免疫组织化学检测,以病理活体组织检查(活检)结果为对照,比较3种检测方法诊断宫颈病变的效能。结果患者宫颈病变越重,HPV-DNA的阳性率和p16表达阳性率越高。与单纯应用HPV-DNA或TCT诊断宫颈病变相比,HPV-DNA与TCT联合检测的灵敏度、特异度、准确性等均较高。此外,HPV-DNA、TCT和p16蛋白联合检测宫颈病变的灵敏度(χ~2=18.596,P<0.001)和特异度(χ~2=16.826,P<0.001)较高,差异有统计学意义。结论 TCT、HPV-DNA联合宫颈脱落细胞p16蛋白免疫组织化学检测可减少漏诊或误诊,提高宫颈癌早期筛查的准确性。
Objective To investigate the value of TLC-based cytology (TCT), high-risk human papillomavirus DNA (HPV-DNA) detection and cervical exfoliated cells p16 protein in early screening of cervical cancer. Methods The hospital from June 2014 to December 2016 using TCT and HPV-DNA combined detection of at least one 900 cases of abnormalities as the research object, the remaining cytological specimens of cervical exfoliated cells p16 protein immunohistochemistry, Pathological biopsy (biopsy) results as a control, the comparison of three detection methods to diagnose the effectiveness of cervical lesions. Results Patients with cervical lesions more severe, the positive rate of HPV-DNA and p16 expression positive rate. Compared with the simple application of HPV-DNA or TCT in the diagnosis of cervical lesions, the combined detection of HPV-DNA and TCT has higher sensitivity, specificity and accuracy. In addition, the sensitivity of HPV-DNA, TCT and p16 protein in detecting cervical lesions was higher (χ ~ 2 = 18.596, P <0.001) and specificity (χ ~ 2 = 16.826, P <0.001), with significant difference. Conclusion Immunohistochemical detection of p16 protein in TCT and HPV-DNA combined with cervical exfoliated cells can reduce the misdiagnosis and misdiagnosis, and improve the accuracy of early screening of cervical cancer.