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目的探讨薄层液基细胞检查(TCT)、HPV-DNA分型联合阴道镜在宫颈癌临床筛选中的应用价值。方法选取1 000例宫颈病变患者的临床资料进行回顾性分析,所有患者均行TCT检测、HPV-DNA分型检测;对检测高度可疑的342例宫颈病变患者同时在阴道镜下进行宫颈活组织检测、病理检测及TCT检测、HPV-DNA分型检测,对检测结果进行观察比较。结果正常及炎症患者的HPV-DNA阳性率与TCT检测低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)组比较差异有统计学意义(P<0.05);意义不明确的非典型鳞状细胞(ASCUS)组HPV-DNA阳性率与HSIL组比较差异有统计学意义(P<0.05),随着TCT检测结果级别的升高,HPV-DNA检测阳性率逐渐升高。经病理学诊断与TCT、HPV-DNA检测结果比较结果显示,随着CIN级别的升高,TCT联合HPV-DNA分型检测双阳性检出率逐渐升高,重度不典型增生(CINIII)及鳞状细胞癌(SCC)检出率最高,与其他组比较差异有统计学意义(P<0.05)。TCT、HPV-DNA分型检测联合阴道镜对宫颈癌筛查检出率提高,漏检率进一步降低。结论应用TCT、HPV-DNA分型检测联合阴道镜对宫颈癌进行筛查是一种高效、快速的筛查方式,能够提高诊断准确率,为宫颈癌的临床治疗提供了诊断依据,在临床上具有重要的应用价值。
Objective To investigate the value of TCT and HPV-DNA typing combined with colposcopy in clinical screening of cervical cancer. Methods The clinical data of 1 000 cases of cervical lesions were retrospectively analyzed. All the patients underwent TCT and HPV-DNA typing tests. 342 patients with highly suspicious cervical lesions underwent colposcopic biopsy under colposcopy , Pathological examination and TCT test, HPV-DNA typing test, the test results were observed and compared. Results The positive rate of HPV-DNA in normal and inflammatory patients was significantly lower than that in LSIL and HSIL group (P <0.05); the significance was not clear (P <0.05). The positive rate of HPV-DNA increased with the increase of TCT test results. The HPV-DNA positive rate of ASCUS group was significantly higher than that of HSIL group (P <0.05). Pathological diagnosis and TCT, HPV-DNA test results showed that, with the CIN level increased, TCT combined HPV-DNA typing detection double positive detection rate gradually increased, severe dysplasia (CINIII) and scales The highest detection rate of SCC was found, which was significantly different from other groups (P <0.05). TCT, HPV-DNA typing detection combined colposcopy screening rate of cervical cancer increased, the missed rate further reduced. Conclusion TCT and HPV-DNA typing combined with colposcopy screening of cervical cancer is an efficient and rapid screening method, which can improve the diagnostic accuracy and provide a diagnostic basis for the clinical treatment of cervical cancer, clinically Has important application value.