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目的探讨薄层液基细胞学检测技术(TCT)、HPV-DNA分型联合阴道镜在宫颈癌筛选中的应用价值。方法选取2014—2015年于灵丘县妇幼保健院行宫颈检查并诊断为宫颈病变的患者927例,均行TCT检测、HPV-DNA分型检测,并对859例高度怀疑为宫颈癌患者在阴道镜下进行宫颈活组织检测、TCT检测、HPV-DNA分型检测及病理检测,对比分析其检查结果。结果 TCT检测为正常或炎症患者HPV-DNA分型检测的阳性率低于TCT检测为低度鳞状上皮内病变及高度鳞状上皮内病变(P<0.05);TCT检测为非典型鳞状上皮细胞病变患者HPVDNA分型检测的阳性率低于TCT检测为高度鳞状上皮内病变及鳞状细胞癌(P<0.05)。TCT、HP-DNA分型检测对病理学检测结果为重度不典型增生及鳞状细胞癌患者的阳性检出率高于轻度、中度不典型增生(P<0.05)。TCT、HPV-DNA及阴道镜联合对轻、中、中度不典型增生的准确率高于TCT与HPV-DNA联合(P<0.05)。结论 TCT、HPV-DNA分型联合阴道镜在宫颈癌筛选中安全、高效,可降低漏诊率。
Objective To investigate the value of TCT and HPV-DNA typing combined with colposcopy in the screening of cervical cancer. Methods Nine hundred and seventy-seven patients with cervical lesions diagnosed as cervical lesions in Lingqiu Maternal and Child Health Hospital from 2014 to 2015 were selected and tested by TCT and HPV-DNA typing. A total of 859 patients with cervical cancer who were highly suspected as cervical cancer in the vagina Microscopic examination of cervical biopsy, TCT, HPV-DNA typing and pathological detection, comparative analysis of the test results. Results The positive rate of HPV-DNA typing detected by TCT in normal or inflammatory patients was lower than that in TCT detected by low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion (P <0.05). TCT was detected in atypical squamous epithelium The positive rate of HPVDNA typing in cytopathic patients was lower than that of TCT detected in highly squamous intraepithelial lesion and squamous cell carcinoma (P <0.05). The positive detection rate of TCT and HP-DNA typing in patients with severe atypical hyperplasia and squamous cell carcinoma was higher than that in mild to moderate atypical hyperplasia (P <0.05). The accuracy rate of TCT, HPV-DNA and colposcopy was higher than that of TCT and HPV-DNA in mild, moderate and moderate atypical hyperplasia (P <0.05). Conclusion TCT and HPV-DNA typing combined with colposcopy are safe and effective in cervical cancer screening, which can reduce the rate of misdiagnosis.