论文部分内容阅读
目的探讨高危型HPV联合细胞学检测在检查宫颈疾病中的临床价值和意义。方法 2015年1月-2016年4月期间郑州大学附属郑州中心医院共对1 749例妇女进行了宫颈癌及癌前病变筛查,分别行HPV-DNA检测及薄层液基细胞学(TCT)检测,对TCT检测异常患者进一步行阴道镜及病理检查。结果 (1)TCT检测1 749例受检者有213例为异常,异常率12.18%,其中不典型鳞状上皮细胞(ASC)84例,占4.80%(84/1 749),低度鳞状上皮内病变(LSIL)者66例,占3.77%(66/1 749),高度鳞状上皮内病变(HSIL)者55例,占3.14(55/1 749),鳞状细胞癌(SCC)者8例,占0.46%(8/1 749)。(2)HPV-DNA检测有526例为阳性,阳性率30.07%,TCT检查异常患者其HPV-NDA检查阳性者共112例,阳性率52.58%(112/213),其中ASC患者阳性率29.76%(25/84),LSIL患者阳性率51.52%(34/66),HSIL患者阳性率81.82%(45/55),SCC阳性率100%(8/8)。(3)213例TCT检查异常患者阴道镜检及病理检查结果显示,慢性宫颈炎者58例(27.23%),宫颈上皮内肿瘤(CIN)139例(65.26%),宫颈浸润癌16例(7.51%)。(4)TCT检测阳性预测值为72.77%,HPV-DNA阳性预测值为18.06%,联合检测阳性预测值为84.82%。TCT、HPV-DNA阳性预测值分别与联合检测阳性预测值比较,差异有统计学意义(P<0.05)。结论高危型HPV及TCT检查均能用于宫颈疾病的筛查,但联合检测阳性率更高。
Objective To investigate the clinical value and significance of high-risk HPV combined cytology in detecting cervical diseases. Methods From January 2015 to April 2016, a total of 1 749 women were screened for cervical cancer and precancerous lesions by Zhengzhou Central Hospital Affiliated to Zhengzhou University. HPV-DNA testing and thin-layer liquid-based cytology (TCT) Detection, TCT abnormalities in patients with further colposcopy and pathological examination. RESULTS: (1) There were 213 abnormalities in 1 749 cases detected by TCT, and the abnormality rate was 12.18%. There were 84 cases of atypical squamous cells (ASC), accounting for 4.80% (84/1 749), with low squamous There were 66 cases of intraepithelial lesion (LSIL), accounting for 3.77% (66/1 749), 55 cases of high grade squamous intraepithelial lesion (HSIL), accounting for 3.14 (55/1 749), squamous cell carcinoma (SCC) 8 cases, accounting for 0.46% (8/1 749). (2) There were 526 HPV-DNA tests positive, the positive rate was 30.07%. The positive rate of HPV-NDA in 112 patients with TCT abnormalities was 112.5% (112/213). The positive rate of HPV in patients with ASC was 29.76% (25/84). The positive rate of LSIL was 51.52% (34/66), the positive rate of HSIL was 81.82% (45/55) and the positive rate of SCC was 100% (8/8). (3) The results of colposcopy and pathological examination of 213 cases with abnormal TCT showed that 58 cases (27.23%) had chronic cervicitis, 139 cases (65.26%) had cervical intraepithelial neoplasia (CIN), 16 cases (7.51% %). (4) The positive predictive value of TCT was 72.77%, the positive predictive value of HPV-DNA was 18.06%, and the positive predictive value of combined detection was 84.82%. The positive predictive value of TCT and HPV-DNA were respectively compared with the positive predictive value of combined detection, the difference was statistically significant (P <0.05). Conclusion High-risk HPV and TCT can be used for cervical disease screening, but the positive rate of combined detection is higher.