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目的探讨分析薄层液基细胞学技术(TCT)、第二代杂交捕获技术(HC-II)检测与组织病理学诊断结果之间的相互关系,为提高宫颈癌早期筛查水平提供参考依据。方法 2010年11月~2013年11月于秦皇岛市妇幼保健院就诊的82 385例患者的宫颈细胞学检测标本中,对其中2 265例TCT诊断异常患者进行HC-II检测及组织病理学诊断。结果 TCT与组织病理学诊断结果比较分析发现,TCT提示为鳞状上皮内高度病变(HSIL)、不除外高度鳞状上皮内病变的不典型鳞状上皮细胞(ASC-H)、鳞状上皮内低度病变(LSIL)、意义不明的不典型鳞状细胞(ASCUS)组的病例与组织病理学诊断符合率及阳性率,分别为62.91%(134/213)、53.42%(39/73)、46.01%(127/276)及54.14%(903/1 668),且各组之间比较差异有统计学意义(P<0.01);HC-II与TCT诊断结果比较,HPV阳性检出率在ASCUS、ASC-H、LSIL、HISL组分别为68.41%(1 141/1 668)、76.71%(56/73)、73.91%(204/276)及86.38%(184/213),且各组之间比较差异有统计学意义(P<0.01);HC-II与组织病理学诊断结果比较,HPV阳性检出率在组织病理学诊断为浸润性癌、CIN II—III级病变及湿疣/CINI级病变组分别为93.80%(15/16)、94.70%(411/434)及88.0%(792/900),且各组之间比较差异有统计学意义(P<0.01)。结论将高危型HPV检测与TCT检测技术相结合应用于早期宫颈癌及癌前病变筛查中,提高了筛查宫颈病变的准确性,是防治宫颈癌的关键。
Objective To explore the relationship between TLC-based cytology (TCT), second-generation hybridization capture (HC-II) and histopathological diagnosis and to provide a reference for improving early screening of cervical cancer. Methods Cervical cytology specimens of 82 385 patients treated in Qinhuangdao MCH hospital from November 2010 to November 2013 were retrospectively analyzed for HC-II and histopathological diagnosis of 2665 TCT patients with abnormal diagnosis. Results Comparing the results of TCT and histopathological diagnosis, it was found that the TCT suggestion was classified as squamous intraepithelial lesion (HSIL), atypical squamous cell (ASC-H) without intraepithelial lesion, squamous intraepithelial neoplasia The coincidence rate and positive rate of LSIL and ASCUS were 62.91% (134/213) and 53.42% (39/73) respectively. The positive rates of LSIL, 46.01% (127/276) and 54.14% (903/1 668), respectively, and there was significant difference among the groups (P <0.01). The positive rate of HPV-positive in HC-II and TCT was higher than that in ASCUS , 68.41% (1 141/1 668), 76.71% (56/73), 73.91% (204/276) and 86.38% (184/213) respectively in ASC-H, LSIL and HISL groups The difference was statistically significant (P <0.01). Compared with histopathological diagnosis, the positive detection rate of HPV was positive in histopathological diagnosis of invasive carcinoma, CIN II-III lesions and genital warts / CINI lesions (93.80%), 94.70% (411/434) and 88.0% (792/900), respectively. The difference between the two groups was statistically significant (P <0.01). Conclusion The combination of high-risk HPV testing and TCT detection technology in early cervical cancer and precancerous lesions screening to improve the accuracy of screening for cervical lesions is the key to the prevention and treatment of cervical cancer.