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目的:探讨液基细胞学联合荧光检测HPV在妇女宫颈病变筛查中的临床价值。方法:2007年12月～2008年10月对广西医科大学第五附属医院妇科门诊2 369例妇女进行TCT检查,其中331例细胞学异常(ASCUS及其以上)患者均行高危型HPV PCR荧光检测,HPV阳性者行阴道镜检查,同时镜下定位活检。以病理结果作为诊断的“金标准”。结果:2 369例妇女中,TCT阳性331例(13.97%),HPV阳性169例(7.13%),331例行阴道镜下宫颈多点活检,细胞学与病理学诊断符合率CINⅠ71.43%(40/56)、CINⅡ/Ⅲ79.25%(42/53)、浸润癌66.67%(8/12);细胞学联合HPV检测与病理组织学诊断符合率CINⅠ87.50%、CINⅡ/Ⅲ92.45%、浸润癌占100.00%。结论:宫颈病变的发生与高危型HPV感染密切相关,CIN与高危型HPV感染呈正相关,荧光HPV检测在宫颈病变筛查中可作为细胞学的辅助手段提高诊断准确性。
Objective: To investigate the clinical value of liquid-based cytology and fluorescence detection of HPV in screening women with cervical lesions. Methods: From December 2007 to October 2008, 2 369 women in gynecology outpatient department of the Fifth Affiliated Hospital of Guangxi Medical University were examined by TCT. Among them, 331 patients with abnormal cytology (ASCUS and above) underwent high-risk HPV PCR detection , HPV-positive colposcopy, while positioning the biopsy. Pathological findings as a diagnostic “gold standard ”. Results: The positive rate of TCT was 331 cases (13.97%), 169 cases (7.13%) were HPV positive and 331 cases were colposcopy biopsy under colposcopy. The coincidence rate of cytology and pathology was 71.43% 40/56), CINⅡ / Ⅲ 79.25% (42/53) and invasive carcinoma 66.67% (8/12). The coincidence rate of cytology and HPV testing was 87.50% for CINⅠ and 92.45% for CINⅡ / Ⅲ, , Invasive cancer accounted for 100.00%. Conclusion: The incidence of cervical lesions is closely related to high-risk HPV infection. CIN is positively correlated with high-risk HPV infection. Fluorescent HPV test can be used as a cytologic aids to improve diagnostic accuracy in screening cervical lesions.