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目的:高危型人乳头瘤状病毒检测(HCⅡ-HPV-DNA)联合液基细胞学(TCT)检查在宫颈病变筛查中的价值。方法:对参加妇科体检的10 000例妇女进行宫颈癌高危因素问卷调查和常规宫颈巴式涂片检查,筛选出具有宫颈癌高危因素或巴氏涂片异常的850例妇女进行HCⅡ-HPV-DNA检测与TCT联合筛查,同时进行阴道镜下活检行组织学检查,并对结果进行分析。结果:HCⅡ-HPV-DNA检测诊断敏感度虽高(90%),但特异性低(70%);TCT检查特异性高(98%),敏感性低(80%),两组特异性比较有显著差别(P<0.01);TCT检查宫颈阳性病例检出率为80%;而HCⅡ-HPV-DNA与TCT联合筛查宫颈阳性病例检出率达97%;两组比较有明显差别(P<0.05)。结论:HCⅡ-HPV-DNA联合TCT进行宫颈癌及宫颈上皮内瘤变的筛查,能明显提高检出率和筛查效率,在子宫颈癌高危人群中进行大规模的初筛更具价值,开辟了子宫颈癌筛查方法的新途径。
Objective: To evaluate the value of high-risk human papillomavirus (HCⅡ-HPV-DNA) combined with liquid-based cytology (TCT) in screening cervical lesions. Methods: A total of 10 000 women who participated in the gynecological examinations were asked to investigate the risk factors of cervical cancer and conventional pap smear, and 850 women with high risk of cervical cancer or Pap smear were screened for HCⅡ-HPV-DNA Detection and TCT joint screening, at the same time colposcopic biopsy histological examination, and the results were analyzed. Results: The detection sensitivity of HCⅡ-HPV-DNA was high (90%) but low (70%), specificity of TCT was 98%, and sensitivity was low (80%). (P <0.01). The detection rate of cervical positive cases by TCT was 80%, while the detection rate of cervical positive cases by HCⅡ-HPV-DNA and TCT was 97%. There was a significant difference between the two groups (P <0.05). Conclusion: The detection of cervical cancer and cervical intraepithelial neoplasia with HCⅡ-HPV-DNA combined with TCT can significantly improve the detection rate and screening efficiency. It is more valuable to carry out large-scale screening in high-risk groups of cervical cancer, Opened up new ways of screening for cervical cancer.