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目的了解南京市秦淮区妇女宫颈病变的发病情况,探讨宫颈细胞学筛查方法联合高危型HPV检测对宫颈癌筛查的有效性。方法 2013年1月-2015年12月对南京市秦淮区普通人群中35岁~64岁的已婚妇女30 113例进行宫颈液基细胞学(TCT)检查及HPV高危型检查。结果 TCT异常(TBS系统≥ASC)638例,细胞学阳性率2.12%,除24例拒绝进一步检查外,其余614例应用PCR-反向点杂交检测法检测高危型HPV,阳性251例,阳性率为40.88%(251/614),其中ASC、LSIL、HSIL、鳞状细胞癌阳性率分别为27.85%(127/456)、70.31%(90/128)、89.19%(33/37)、100.00%(1/1),随着细胞学级别的增加,高危型-HPV阳性率越高;213例TCT检查阴性者,HR-HPV阳性率为10.33%(22/213)。TCT阳性、HRHPV阳性者中,病理学阳性率为42.23%(106/251),而TCT阳性、HR-HPV阴性者中,病理学阳性率为19.80%(20/101),两组阳性率比较有统计学差异(P<0.05)。结论 TCT联合HR-HPV检测能提高宫颈病变的检出率,二者结合更有利于宫颈病变的科学管理。
Objective To understand the incidence of cervical lesions in Qinhuai District of Nanjing City and to explore the effectiveness of cervical cytology screening combined with high-risk HPV testing in cervical cancer screening. Methods From January 2013 to December 2015, 30 113 married women aged 35 to 64 years from the general population in Qinhuai District of Nanjing City were tested for cervical liquid-based cytology (TCT) and HPV high-risk type. Results There were 638 cases with TCT abnormality (TAS system ≥ASC) with a positive rate of cytology 2.12%. All the 614 cases rejected high risk HPV by PCR-reverse dot blot assay except for 24 cases, with a positive rate of 251 The positive rates of ASC, LSIL, HSIL and squamous cell carcinoma were 27.85% (127/456), 70.31% (90/128), 89.19% (33/37) and 100.00% (1/1). With the increase of cytology level, the positive rate of high-risk type-HPV was higher. The positive rate of HR-HPV in 213 cases with negative TCT was 10.33% (22/213). Among TCT positive and HRHPV positive patients, pathological positive rate was 42.23% (106/251), while in TCT positive and HR-HPV negative, pathological positive rate was 19.80% (20/101) There was a significant difference (P <0.05). Conclusion TCT combined with HR-HPV test can improve the detection rate of cervical lesions, the combination of the two is more conducive to the scientific management of cervical lesions.