TCT、HPV-DNA分型及阴道镜在宫颈癌筛查中的应用

摘要

Objective Evaluate the value of TCT and HPV-DNA technique combined colposcope examination as for screening early changes of uterine cervix.Methods 2820 patients have been screened for cervical lesion at gynecological clinic from January 2011 to December 2012.1047 cases were examined with Colposcopy combined with cervical biopsy after they were positive by normal regulations checks of TCT and HPV-DNA,then compare the results respectively.Results The positive rate rises signiifcantly along with TCT grading,and the rate is almost 100%in SCC.With TCT and HPV-DNA test,the double positive rate increases along with the CIN grading and it reach the highest level at CINIII or higher. TCT and HPV-DNA test combined colposcope examination may bring a high diagnostic rate and low misdiagnosis rate.Conclusion TCT and HPV-DNA test combined colposcope examination is an rapid and efifcient method for cervical precancerous lesion screening.It is useful on improving the detection rate and reducing the rate of misdiagnosis,also profounding guiding signiifcance for follow-up intervals.%目的分析HPV、TCT联合阴道镜检查在早期宫颈病变筛查中的意义。方法选择2011年1月-2012年12月芷江侗族自治县人民医院收治的宫颈病变筛查的患者2820例，所有病例均进行HPV-DNA分型检测、TCT检查，对TCT阳性或HPV-DNA检测阳性或临床高度怀疑宫颈病变1047例患者，同时行阴道镜下宫颈活组织检查，并以宫颈活检的组织病理学结果为确诊标准，将其病理结果与HPV、TCT结果对照分析。结果随着TCT级别的升高HPV-DNA 阳性率明显升高，在SCC中，HPV-DNA阳性率达100%；TCT联合HPV-DNA分型检测在以上病例中双阳性检出率随CIN级别升高而升高，CINI I及以上达最高，在SCC中达到了100%；TCT联合HPV-DNA分型检测在阴道镜下活检对宫颈病变的检出率增高，漏诊率降低。结论应用HPV-DNA、TCT及阴道镜进行宫颈癌前病变的筛查，是一种高效、便捷的筛查方法，能明显提高子宫颈癌及癌前期病变的检出率，降低漏诊率，并指导随访间隔时间具有重要意义。