薄层液基细胞学与HPV基因检测在宫颈病变筛查中的对比研究

摘要

Objective: To evaluate the consistency of cervical cytology change and HPV gene in the cervix lesions. Methods : In 2010 April,out women patients were checked hy thinprep cytology test( TCT ), who were given a clinical diagnosis by TBS. Meanwhile collecting their TCT specimens tested by HPV general primer polymerase chain reaction( PCR ),and withβ - globin gene as internal reference. Results : In 159 cases , the positive rate of TCT was 3. 14％ ,including 2 cases of atypical squamous cell of undetermined significance( ASC - US ),2 cases of low level squamous epithelial inside lesion( LSIL ) , 1 case with high level squamous epithelial inside lesion( HSIL ). HPV DNA positive rate was 11. 32％ .2 cases of ASC - US,2 cases of LSIL and 1 case of HSIL were HPV DNA positive, and 9 cases of moderate inflammation and 4 cases of mild inflammation were HPV DNA positive. The positive rate of TCT method was lower than PCR method nearly 4 times. Conclusion : By TCT were diagnosed some women asbenign inflammation,who were found virus DNA by PCR, namely HPV DNA has invaded the cervix cells, but may not appear the change of cell morphology on visual inspection.%目的:评价宫颈病变中宫颈细胞学改变与HPV病毒基因存在的一致性.方法:本院妇科门诊2010年4月份首诊病人进行薄层液基细胞学(Thinprep cytology test TCT)检查,以TBS诊断标准给出临床诊断.同时收集其宫颈TCT剩余标本,进行HPV通用引物聚合酶链反应(Personal Thermal Cycler PCR)检测,并以β-globin基因作为内参照.结果 159例标本中,TCT检查阳性检出率为3.14%,包括2例意义不明确的非典型鳞状细胞(ASC-US),2例低级别鳞状上皮内病变(LSIL),1例高级别鳞状上皮内病变(HSIL).HPV DNA阳性检出率达11.32%,2例ASC-US、2例LSIL和1例HSIL都是HPV DNA阳性,9例中度炎症和4例轻度炎症也检测到HPV DNA.TCT方法的阳性检出率低于PCR方法近4倍.结论:TCT检查诊断为良性炎症的标本通过PCR扩增发现病毒DNA,即病毒DNA已经侵入了宫颈细胞,但可能还没有出现细胞形态学改变.