高危型HPV联合TCT检测在宫颈病变Leep术后的应用价值

摘要

目的 探讨高危型人乳头瘤病毒(high-risk human papilloma virus,HR-HPV)联合液基薄层细胞学检测( liquid-based thinprep cytology test,TCT)在宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)行宫颈环形电切术( loop electrosurgical excision procedure,Leep) 后的临床应用价值.方法 回顾性对比分析528例患者,经术前HR-HPV、TCT检测并宫颈活检病理确诊≥CINⅠ,Leep术后接受HR-HPV联合TCT检测随访12-36个月.结果 术前所有病例TCT≥ASCUS,术后3月、6月、12月、18月、24月、30月和36月随访TCT异常率分别为0.12%(1/528)、2.84%(15/528)、1.33%(7/528)、1.17%(6/528)、0.76%(4/528)、0.38%(2/528)、0%;HR-HPV阳性率分别为0%(未查)、26.89%(142/528)、19.32%(102/528)、12.12%(64/528)、6.06%(32/528)、3.60%(19/528)、2.46%(13/528);术后病变持续或复发的23例,HR-HPV联合TCT双项检测病理诊断符合率为91.30%.结论 Leep术后HR-HPV联合TCT检测对评判手术效果及术后随访、预防宫颈病变复发具有较高的临床应用价值.%Objective To investigate the clinical application value of the high-risk human papillomavirus (high-risk human papilloma virus, HR-HPV) and the ThinPrcp cytology (liquid-based thinprcp cytology test,TCT) detection of cervical intracpithclial ncoplasia-likc lesions (cervical intracpithclial ncoplasia,CIN) after the cervical loop clcctrosurgi-cal excision procedure (loop clcctrosurgical excision procedure, LEEP). Methods A retrospective comparative analysis of 528 patients that had prcopcrativc HR-HPV,TCT detection and cervical biopsy diagnosed ≥ CIN I;and had postoperative TCT and HR-HPV detection followed up for 12-36 months post LEEP. Results TCT ≥ ASCUS during prc-opcration for all cases analysed. During post-operation, the TCT abnormal rates were 0. 12% (1/528),2. 84% (15 / 528),1.33% (7/528),1. 17% (6/528) ,0. 76% (4/528) ,0. 38% (2/528) ,0% ; and the HR-HPV positive rates were 0% (unchecked),26. 89% (142/528) , 19. 32% (102/528) , 12. 12% (64/528) ,6. 06% (32/528) ,3. 60% (19/528),2. 46% (13/528) for 3 months,6 months, 12 months, 18 months, 24 months, 30 months and 36 months follow-up detection respectively after LEEP. For the sample of 23 patients with persistent or recurrent postoperative lesions, the pathological diagnosis rate of HR-HPV test and TCT detection was 91. 30%. Conclusion The post Leep HR-HPV test and TCT detection has a high clinical application value in evaluating the surgery outcome and postoperative follow-up, and in preventing the recurrence of cervical lesions