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目的探讨液基薄层细胞学技术(TCT)与高危型人乳头状瘤病毒(HR-HPV)联合检测对筛查宫颈癌和宫颈早期病变的临床意义。方法宫颈癌普查的体检者520例,采用TCT和HR-HPV分型检测,后者用导流杂交基因芯片技术(HybriMax)。分析联合检测对宫颈早期病变筛查的价值。结果 TCT检测中有148例出现细胞学异常,检出率28.5%(148/520);其中,非典型鳞状细胞癌(ASC)105例,低度鳞状上皮内病变(LSIL)32例,高度鳞状上皮内病变(HSIL)10例,宫颈鳞状细胞癌(SCC)1例。HR-HPV阳性率39.8%(207/520)。TCT阳性结果病例中,HR-HPV的阳性率分别为ASC 77.1%(81/105),LSIL 84.4%(27/32),HSIL 90.0%(9/10),SCC 100.0%(1/1)。HR-HPV的阳性率随着宫颈病变级别增高而增高。结论 HR-HPV阳性率与细胞学分级密切相关;HR-HPV检测能降低TCT检测的假阴性率,两者联合检测对宫颈癌和宫颈病变的早期诊断有重要意义。
Objective To investigate the clinical significance of combined detection of liquid-based thin-layer cytology (TCT) and high-risk human papillomavirus (HR-HPV) in the screening of cervical cancer and early cervical lesions. Methods The physical examination of cervical cancer in 520 cases, using TCT and HR-HPV typing test, the latter by flow-through hybridization gene chip technology (HybriMax). Analysis of joint detection of early cervical lesions screening value. Results There were 148 cases of cytological abnormalities in TCT test, the detection rate was 28.5% (148/520). Among them, 105 cases of atypical squamous cell carcinoma (ASC), 32 cases of low grade squamous intraepithelial lesion (LSIL) High grade squamous intraepithelial lesion (HSIL) in 10 cases, cervical squamous cell carcinoma (SCC) in 1 case. The HR-HPV positive rate was 39.8% (207/520). The positive rate of HR-HPV was 77.1% (81/105) in ASC, 84.4% (27/32) in LSIL, 90.0% (9/10) in HSIL and 100.0% (1/1) in SCC respectively. The positive rate of HR-HPV increased with the increase of cervical lesions. Conclusion The positive rate of HR-HPV is closely related to the grade of cytology. The detection of HR-HPV can reduce the false negative rate of TCT. The combined detection of HR-HPV and HPV is of great significance in the early diagnosis of cervical cancer and cervical lesions.