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目的分析高危型人乳头状瘤病毒(HR-HRV)检查、宫颈脱落细胞病理检查及宫颈组织病理学活检在早期宫颈癌及宫颈癌前病变中的应用价值。方法选取当阳市中医医院于2010—2016年收治的宫颈癌患者4519例,分别采用宫颈脱落细胞病理检查、HR-HPV检查、组织病理学活检,比较3种检查对宫颈癌检查情况。结果4519例接受宫颈脱落细胞病理活检筛查的女性中,根据细胞学与组织学诊断可以相差一级的原则,低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)及鳞状细胞癌抗原(SCC)与组织病理学活检结果的符合率分别为45.03%(263/584)、74.19%(69/93)、94.44%(34/36),随着分级升高,诊断符合率相应升高,且各组比较结果之间均有统计学差异(P<0.05)。比较宫颈脱落细胞病理活检中LSIL及以上患者与组织病理学活检中CIN1及以上患者的HPV阳性率,可见其分布为65.92%和73.14%,组织病理学活检中CIN1级以上患者中的HPV阳性率更高,但比较无统计学差异(P>0.05),不同分级患者的HPV阳性率比较也无明显差异(P>0.05)。结论 HR-HRV检查、宫颈脱落细胞病理检查及宫颈组织病理学活检联合应用有利于提高宫颈癌前病变及宫颈癌的检出率。
Objective To analyze the value of high-risk human papillomavirus (HR-HRV), cervical exfoliative cell pathology and cervical histopathology in the early stage of cervical cancer and precancerous lesions. Methods 4519 cases of cervical cancer admitted by Dangyang Hospital of Traditional Chinese Medicine from 2010 to 2016 were selected. Cervical cancer was examined by cervical exfoliated cell pathology, HR-HPV examination and histopathology biopsy respectively. Results Among the 4519 women who underwent biopsy of cervical exfoliative cells, according to the principle that cytology and histology can be differentiated by one grade, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and The coincidence rates of SCC and histopathological biopsy were 45.03% (263/584), 74.19% (69/93) and 94.44% (34/36), respectively. With the increase of grade, diagnosis The coincidence rate increased accordingly, and there was a significant difference between the groups (P <0.05). The positive rates of HPV in LSIL patients with cervical exfoliative cell biopsy and those with CIN1 and above in histopathological biopsy were 65.92% and 73.14%, respectively. The positive rate of HPV in CIN1 patients with histopathological biopsy (P> 0.05). There was no significant difference in the positive rate of HPV among different grading patients (P> 0.05). Conclusion The combination of HR-HRV, cervical exfoliative cell pathology and cervical biopsy can improve the detection rate of cervical precancerous lesions and cervical cancer.