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目的探讨液基薄层细胞学(TCT)和人乳头瘤病毒(HPV)检测在宫颈癌前病变中的筛查价值。方法回顾性分析具有宫颈活体组织检查(活检)组织病理学检查结果的1 025例患者的TCT及HPV检查结果,以组织病理学结果为确诊标准,比较分析TCT检查、HPV检测及两者联合筛查宫颈癌前病变的价值。结果阴道镜下宫颈活检组织病理学检查结果作为标准,组织病理学诊断正常或炎症患者的高危型HPV感染阳性率与低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)及宫颈鳞状细胞癌(SCC)患者的高危型HPV感染阳性率比较差异具有统计学意义(χ~2=211.77,P=0.000 0);TCT检查结果级别越高,筛查假阴性率越低,各组患者间比较差异有统计学意义(χ~2=11.00,P=0.011 7)。随着TCT检查结果级别的升高,组织病理学级别升高(χ~2_(趋势)=691.22,P=0.000 0);TCT联合HPV检测的灵敏度明显高于单独TCT检查及HPV检测。结论TCT联合HPV筛查能降低宫颈癌筛查的漏诊率,是最为理想的宫颈癌筛查方法。
Objective To investigate the screening value of liquid-based cytology (TCT) and human papillomavirus (HPV) in cervical precancerous lesions. Methods The TCT and HPV test results of 1 025 patients with cervical biopsy histopathology were analyzed retrospectively. The histopathological results were used as the diagnostic criteria, and the results of TCT, HPV and combined screening Check the value of cervical precancerous lesions. Results Colposcopy biopsy histopathological examination results as a standard, histopathological diagnosis of normal or inflammatory patients with high-risk HPV infection positive rate and low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) (Χ ~ 2 = 211.77, P = 0.000 0). The higher the TCT test results, the lower the false negative rate of screening There was significant difference between the groups (χ ~ 2 = 11.00, P = 0.011 7). As the level of TCT increased, the level of histopathology increased (χ ~ 2_ (trend) = 691.22, P = 0.000 0). The sensitivity of TCT combined with HPV test was significantly higher than that of TCT alone and HPV test. Conclusion TCT combined with HPV screening can reduce the misdiagnosis rate of cervical cancer screening, which is the most ideal screening method for cervical cancer.