高危型人乳头瘤病毒联合液基薄层细胞检测对宫颈癌前病变的诊断价值

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目的探讨高危型人乳头瘤病毒(HR-HPV)联合液基薄层细胞检测(TCT)对宫颈癌前病变筛查的应用及诊断价值。方法收集2010年5月至2011年12月门诊初次就诊患者433例,所有患者均行宫颈薄层液基细胞学(TCT)检查和13种HR-HPV检查,HR-HPV和(或)TCT任一项或两项结果异常者均进行阴道镜下病理组织学检查,以病理组织学为诊断金标准。结果 433例患者中,HPV阳性91例,阳性率21.0%,TCT阳性69例,阳性率15.9%。以病理组织学为金标准,单独应用HPV检测对于≥CIN1的阳性预测值为73.6%(67/91),而单独应用TCT检测,阳性预测值为73.9%(51/69);当HPV联合TCT检测时,阳性预测值为90.5%(38/42),阳性预测值比单独HR-HPV或TCT检测均显著提高。结论 HR-HPV联合TCT检测是对妇科门诊初次就诊患者宫颈病变筛查的有效方法。 Objective To investigate the application and diagnostic value of high-risk human papilloma virus (HR-HPV) combined with liquid-based thin-layer cytometry (TCT) screening of cervical precancerous lesions. Methods A total of 433 primary inpatients from May 2010 to December 2011 were collected. All patients underwent cervical smear-based cytology (TCT) and 13 HR-HPV tests. HR-HPV and / or TCT One or two abnormal results were colposcopy histopathological examination to histopathological diagnosis of gold standard. Results Of the 433 patients, 91 were positive for HPV, the positive rate was 21.0%. The positive rate of TCT was 69, the positive rate was 15.9%. With histopathology as the gold standard, the positive predictive value for HPV ≥6 was 73.6% (67/91) with HPV alone, while the positive predictive value was 73.9% (51/69) with TCT alone. When HPV combined with TCT At the time of detection, the positive predictive value was 90.5% (38/42), and the positive predictive value was significantly higher than that of HR-HPV or TCT alone. Conclusion HR-HPV combined with TCT detection is an effective method for screening cervical lesions in the first visit of gynecological clinic.
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