摘要
目的了解保定地区女性子宫颈癌及癌前病变的流行特点,探讨薄层液基细胞学检查(TCT)与人乳头瘤病毒(HPV)分型联合检测对子宫颈癌及癌前病变筛查的临床意义。方法选取于保定市妇幼保健院妇科门诊行子宫颈病变筛查病例9867例,同时行TCT与HPV分型检测,对TCT和(或)HPV分型检测结果阳性者行阴道镜及组织病理学检查,并以组织病理结果作为诊断标准,对比分析TCT、HPV分型检测及两者联合检测在子宫颈癌及癌前病变筛查中的诊断价值。结果9867例受检者中TCT和HPV分型检测阳性人数分别为741例(7.51%)和1771例(17.9%)。对717例TCT和(或)HPV分型检测阳性者行阴道镜和组织病理学检查,共检出阳性病例602例,阳性率为83.96%,其中低级别鳞状上皮内病变(LSIL/CINⅠ)455例(63.46%),高级别鳞状上皮内病变(HSIL/CINⅡ-Ⅲ)130例(18.13%),鳞癌13例(1.81%),腺癌4例(0.56%)。以组织病理学结果为诊断标准,TCT、HPV分型检测以及两者联合检测阳性病例中筛查出子宫颈癌及癌前病变的人数为401例、565例及602例,分别占总筛查人数的55.93%(401/717)、78.80%(565/717)及83.96%(602/717),TCT与HPV分型检测两者联合筛查的病理阳性率显著高于单独行TCT和HPV分型检测,差异有统计学意义(P<0.05)。结论TCT与HPV分型检测联合筛查可提高宫颈癌及癌前病变的检出率,减少漏诊,是相对准确、可靠的筛查方法。
Objective To investigate the epidemiological characteristics of cervical cancer and precancerous lesions among women in Baoding area,and to explore the clinical significance of combined ThinPrep cytologic test(TCT)and human papillomavirus(HPV)genotyping in screening for cervical cancer and precancerous lesions.Methods A total of 9,867 women who were screened for cervical lesions at the Gynecology Clinic of Maternal and Child Health Hospital of Baoding City were selected.All patients underwent both TCT and HPV genotyping testing.The patients with positive results of TCT and/or HPV genotyping were subject to colposcopy and histopathological examination,with histopathological results as the diagnostic criteria.The diagnostic values of TCT alone,HPV genotyping alone,and their combination in screening for cervical cancer and precancerous lesions were compared and analyzed.Results Among the 9,867 subjects,the number of positive cases for TCT and HPV genotyping was 741(7.5%)and 1,771(17.9%),respectively.A total of 717 cases with positive TCT and/or HPV genotyping underwent colposcopy and histopathological examination.among whom 602 cases(83.96%)were histopathologically positive.Specifically,there were 455 cases(63.46%)of low-grade squamous intraepithelial lesion(LSIL/CINⅠ),130 cases(18.13%)of high-grade squamous intraepithelial lesion(HSIL/CINⅡ-Ⅲ),13 cases(1.81%)of cervical squamous cell carcinoma,and 4 cases(0.56%)of cervical adenocarcinoma.With histopathological results as the diagnostic criteria,the number of cervical cancer and precancerous lesions detected by TCT alone,HPV genotyping alone,and their combination was 401,565,and 602 cases,accounting for 55.93%(401/717),78.80%(565/717),and 83.96%(602/717)among the total screened cases,respectively.The histopathological positivity rate of TCT and HPV genotyping combined screening was significantly higher than that of TCT alone or HPV typing alone,with a statistically significant difference(P<0.05).Conclusion Combined screening with TCT and HPV genotyping can improve the detection rate of cervical cancer and precancerous lesions,reduce missed diagnoses,and is a relatively accurate and reliable screening method.
作者
李丽
刘佳麒
吴瑞
臧鹏
温实
LI Li;LIU Jiaqi;WU Rui;ZANG Peng;WEN Shi(Department of Pathology,Maternal and Child Health Hospital of Baoding City,Baoding 071000,China)
出处
《诊断病理学杂志》
2025年第12期1641-1644,共4页
Chinese Journal of Diagnostic Pathology
基金
保定市科技计划项目(编号:1941ZF067)。
关键词
宫颈癌
宫颈癌前病变
液基细胞学检查
人乳头瘤病毒
联合筛查
Cervical cancer
Cervical precancerous lesions
ThinPrep cytologic test
Human papillomavirus
Combined screening
