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目的探讨人乳头瘤病毒DNA(HPV-DNA)分型检测联合宫颈液基薄层细胞学检查(TCT)在宫颈癌筛查工作中的应用价值。方法选取该院2013年9月-2015年9月接受宫颈癌筛查的400例患者为研究对象,所选患者均采取病理学检查,HPV-DNA筛查和TCT检查,比较HPV-DNA、TCT和HPV-DNA+TCT 3种方法在宫颈癌筛查中的诊断价值。结果慢性炎症或无上皮内瘤变和恶性病变(NILM)252例,低度鳞状上皮内病变(LSIL)110例,高度鳞状上皮内病变(HSIL)34例和鳞状细胞癌(SCC)4例,病理学检查阳性率为37.00%。患者HPV-DNA检查阳性率为38.50%(154/400),TCT阳性率为41.50%(166/400)。HPV-DNA灵敏度为75.32%,特异度为86.99%;TCT的灵敏度为71.08%,特异度为87.18%;HPVDNA+TCT的灵敏度为84.52%,特异度为97.41%,差异有统计学意义(P<0.05)。结论 HPV-DNA联合TCT应用于宫颈癌的筛查诊断价值明显优于单独应用,HPV-DNA联合TCT诊断对宫颈癌和癌前病变的筛查意义重大。
Objective To investigate the value of human papillomavirus DNA (HPV-DNA) typing in combination with cervical cytology-based thin-layer cytology (TCT) in cervical cancer screening. Methods 400 patients who underwent cervical cancer screening from September 2013 to September 2015 in our hospital were enrolled in this study. The selected patients were examined by pathology, HPV-DNA screening and TCT. HPV-DNA, TCT And HPV-DNA + TCT three methods in the diagnosis of cervical cancer in the diagnostic value. Results There were 252 cases of chronic inflammation or no intraepithelial neoplasia and malignant transformation (NILM), 110 cases of low grade squamous intraepithelial lesion (LSIL), 34 cases of high grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SCC) 4 cases, the positive rate of pathological examination was 37.00%. The positive rate of HPV-DNA examination was 38.50% (154/400) and the positive rate of TCT was 41.50% (166/400). The sensitivity and specificity of HPV-DNA were 75.32% and 86.99% respectively. The sensitivity and specificity of TCT were 71.08% and 87.18% respectively. The sensitivity and specificity of HPV DNA + TCT were 84.52% and 97.41%, respectively, with significant difference (P < 0.05). Conclusion The value of HPV-DNA combined with TCT in the screening of cervical cancer is obviously better than that of HPV-DNA combined with TCT in the screening of cervical cancer and precancerous lesions.