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目的探讨联合应用hTERC、HPV检测及液基细胞学检查在宫颈癌筛查中的应用价值。方法收集2013年1月-2016年6月因宫颈疾病接受TCT检查的280例患者,进行高危HPV感染检测、hTERC基因扩增FISH检测及阴道镜下病理活组织检查,以病理学结果为金标准,将患者分为5组:炎症组(非CIN)、CIN1组、CIN2组、CIN3组和浸润癌组。比较TCT、hTERC、HPV检测在CIN筛查中的价值。结果 5组TCT检查与病理学结果吻合率分别为90.9%、59.6%、70.5%、66.7%及80.0%;炎症组高危HPV感染率低于CIN组,差异有统计学意义(P<0.01),CIN组与宫颈浸润癌组差异无统计学意义(P>0.05);hTERC基因扩增率高级别CIN组及浸润癌组明显高于低级别CIN组;联合应用3种检测手段灵敏度和特异度最高,分别为98.5%和92.3%。结论 3种方法联合检测优于单一方案,可以极大地提高宫颈癌高度病变的检出率。
Objective To investigate the value of combined application of hTERC, HPV and liquid-based cytology in cervical cancer screening. Methods A total of 280 patients with cervical disease undergoing TCT from January 2013 to June 2016 were enrolled in this study. High-risk HPV infection, FISH detection of hTERC gene amplification and pathological biopsy under colposcopy were performed. The pathological results were taken as the gold standard The patients were divided into 5 groups: inflammatory group (non-CIN), CIN1 group, CIN2 group, CIN3 group and invasive carcinoma group. Compare the value of TCT, hTERC and HPV in CIN screening. Results The coincidence rates of TCT and pathology in the 5 groups were 90.9%, 59.6%, 70.5%, 66.7% and 80.0% respectively. The high risk HPV infection rate in the inflammation group was lower than that in the CIN group (P <0.01) There was no significant difference between CIN group and invasive cervical carcinoma group (P> 0.05). The rate of hTERC gene amplification in high grade CIN group and invasive carcinoma group was significantly higher than that in low grade CIN group. The combination of three detection methods had the highest sensitivity and specificity , Respectively 98.5% and 92.3%. Conclusion The three methods combined detection is superior to single program, which can greatly improve the detection rate of cervical lesions.