摘要
目的评价薄层液基细胞学检测（TCT）和人类乳头状瘤病毒（HPV）检测在子宫颈病变诊断中的临床应用价值。方法对525例TCT提示为炎症和细胞学异常的患者进行HPV检测和阴道镜活组织检查病理分析。结果TCT结果为未明确意义的不典型鳞状上皮细胞（ASC—US）、低度鳞状上皮内病变（LSIL）、高度鳞状上皮内病变（HSIL）和癌瞵状细胞癌（SCC）和腺癌（AC）]的患者，其组织病理诊断为轻度不典型增生（CINI）及以上病变的比例分别为55％（160／290）、88％（99／113）、92％（24／26）和100％（4／4）。其中441例TCT阳性患者，病理诊断炎症和腺体鳞化共148例，假阳性率34％；84例TCT阴性患者中子宫颈中、重度糜烂或有子宫颈息肉的患者病理诊断为CINI及以上病例22例，即TCT假阴性率26％，TCT与组织病理诊断结果差异有统计学意义（χ^2=815．4，P=0．000）。其中74％HPV阳性患者病理学诊断为CINI及以上病变，HPV检查与组织病理诊断结果差异有统计学意义（χ^2=104．94，P=0．000）。年龄≤30岁组病理诊断为阳性患者中CINⅠ占62％（61／98），CINⅡ及以上仅为38％（37／98），无癌的发生；而〉30岁组病理诊断为阳性患者中CINⅠ仅占37％（81／217），但CINⅡ及以上比例明显增加[63％（136／217）]，且癌有所增加，两组差异有统计学意义（χ^2=63．71，P=0．012）。子宫颈光滑组中CINI及以上患者占所有病理诊断阳性结果的26％（83／315），子宫颈糜烂者占74％（232／315），其中14例癌症均发生在子宫颈糜烂患者中，两组差异有统计学意义（χ^2=39．9，P=0．014）。结论TCT和HPV在子宫颈病变筛查中起着重要的作用。
Objective To evaluate the clinical value of liquid-based thinprep cytology test （TCT） and human papillomavirus （HPV） in cervical lesions diagnosis. Methods 525 patients with TCT was inflammation and abnormalities had HPV testing and colposcopy with biopsy analysis. Results Histopathological diagnosis as CIN Ⅰ or CIN Ⅰ above cases percentage of TCT of ASCUS, LSIL, HSIL, and cancer cases were 55 % （160/290）, 88 % （99/113）, 92 % （24/26） and 100 % （4/4）, Pathological diagnosis as inflammation and glandular phosphate in 441 cases of this TCT-positive patients were 148 patients, false positive 34 %. TCT-negative patients, pathologically confirmed of CIN in 84 cases patients with moderate to severe cervical erosion or cervical polyps were 22 cases, 26 % TCT false negative, They had statistically significance （χ^2 = 815.4, P =0.000）. 74 % HPV positive patients diagnosed as CIN Ⅰ or CIN Ⅰ above （χ^2 = 104.94, P = 0.000）. Diagnosed as CIN I cases in less than 30 years old accotmted for 62 % （61/98）, CIN Ⅱ and above for only 38 % （37/98） and without cancer. But the CIN Ⅰ in above 30 age group was significantly reduced to only 37 % （81/217）, CIN Ⅱ and above was significantly increased to 63 % （136/217）, and cancer rate increased （χ^2 = 63.71, P =0.012）. Histopathological diagnosed as CIN I case were 26 % （83/315） of cervical smooth, 74 % （232/315） of cervical erosion; 14 cases of cancer occurred in patients with cervical erosion. It was statistically significant （χ^2 = 39.9, P = 0.014）. Conclusion TCT and HPV for screening of cervical lesions play an important role in cervical lesions screening.
出处
《肿瘤研究与临床》
CAS
2011年第11期762-764,771,共4页
Cancer Research and Clinic
关键词
宫颈疾病
细胞学技术
乳头瘤病毒科
Uterine cervical diseases
Cytological techniques
Papillomaviridae
