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目的探讨宫颈液基细胞学(TCT)联合高危型人乳头状瘤病毒(HR-HPV)检测在宫颈疾病诊断中的临床意义。方法对2009年1月至2009年12月在本院门诊就诊的妇女进行TCT检查,检查结果异常者(163例)行HR-HPV检测及阴道镜下活检或宫颈搔刮术,其中ASC、AGC 81例,LSIL51例,HISL 29例,宫颈浸润癌(SCC)2例。结果组织病理学诊断为正常或炎症(NILM)82例,宫颈上皮内瘤变(CIN)I 33例,CINⅡ31例,CINⅢ14例,SCC 3例。TCT检查与组织病理学检查总体符合率为49.69%(81/163),其中ASC、AGC符合率29.63%(24/81),LSIL符合率54.90%(28/51),HISL符合率93.10%(27/29),SCC符合率100%(2/2),ASC、AGC+LSIL与HISL+SCC符合率相比差异有统计学意义(P<0.05)。TCT联合HR-HPV检测与组织病理学检查总体符合率80.56%(58/72),其中ASC、AGC组符合率66.67%(14/21),LSIL符合率76.92%(20/26),HISL符合率95.65%(22/23),SCC符合率100%(2/2),ASC、AGC+LSIL与HISL+SCC符合率相比差异无统计学意义(P>0.05)。TCT与TCT联合HR-HPV检测的总体符合率比较,差异有统计学意义(P<0.01)。TCT检查中,ACS、AGC与与组织病理学检查的符合率和TCT联合HR-HPV检测相比,差异有统计学意义(P<0.01),而LISL、HISL及SCC的符合率与TCT联合HR-HPV检测相比,差异无统计学意义(P均>0.05)。结论 TCT在低度宫颈病变中的临床诊断价值较在高度宫颈病变中为低,TCT联合HR-HPV检测可提高在低度宫颈病变中的临床诊断价值,从而提高在宫颈疾病诊断中的价值。
Objective To investigate the clinical significance of cervical fluid-based cytology (TCT) combined with high-risk human papilloma virus (HR-HPV) in the diagnosis of cervical diseases. Methods From January 2009 to December 2009, TCT was performed in outpatient clinics in our hospital. The results of abnormal TCT (163 cases) were examined by HR-HPV and colposcopy biopsy or cervical scraping. Among them, ASC, AGC 81 cases, LSIL51 cases, HISL29 cases, cervical invasive carcinoma (SCC) in 2 cases. Results Tissue pathology was diagnosed as normal or inflammatory (NILM) in 82 cases, cervical intraepithelial neoplasia (CIN) I in 33 cases, CIN Ⅱ in 31 cases, CIN Ⅲ in 14 cases and SCC in 3 cases. The overall coincidence rate of TCT and histopathological examination was 49.69% (81/163). The coincidence rate of ASC and AGC was 29.63% (24/81), LSIL coincidence rate was 54.90% (28/51), HISL coincidence rate was 93.10% 27/29). The coincidence rate of SCC was 100% (2/2). There was significant difference in the coincidence rate of ASC, AGC + LSIL and HISL + SCC (P <0.05). The overall coincidence rate of TCT combined with HR-HPV test and histopathological examination was 80.56% (58/72). The coincidence rate of ASC and AGC was 66.67% (14/21), LSIL coincidence rate was 76.92% (20/26) There was no significant difference in the coincidence rate of ASC, AGC + LSIL and HISL + SCC between 95.65% (22/23) and 100% (2/2) of SCC. The overall coincidence rate between TCT and TCT combined with HR-HPV test was statistically significant (P <0.01). TCT examination, ACS, AGC and histopathological examination and TCT combined with HR-HPV detection, the difference was statistically significant (P <0.01), while the coincidence rate of LISL, HISL and SCC with TCT combined with HR -HPV test compared, the difference was not statistically significant (P all> 0.05). Conclusions The clinical diagnostic value of TCT in patients with low cervical lesions is lower than that in patients with severe cervical lesions. The detection of TCT combined with HR-HPV can improve the clinical diagnostic value in low cervical lesions and improve the diagnostic value of cervical lesions.