液基细胞学制片技术与人乳头瘤病毒L1壳蛋白检测对子宫颈病变诊断及进展风险评估

摘要

Objective:To discuss the clinical value of liquid based cytology test in the diagnosis of cervical lesions and to evaluate the expression and significance of human papilloma virus L1(HPV L1)protein in exfoliative cells of different cervical lesions.Methods:A total of 1400 cases visiting gynaecological clinics of our hospital from January 2009 to August 2013 were se-lected and were given liquid based cytology test (LCT)examination and HPV L1 protein expression detection in exfoliative cells.Meanwhile,cervical biopsy pathology results were taken as baseline for make a comparison.Results:(1)Out of 1400 ca-ses,there were 30 cases with LCT(+),accounting for 2.1%,18 cases with HPV L1 protein detection(+),accounting for 1. 29%;8 cases with LCT and HPV L1 protein detection(+),1360 cases with LCT and HPV L1 protein detection(-).(2) Pathological tissue biopsy was performed on 30 cases of patients with LCT(+),results showed that there were 23 cases with positive result.Pathological tissue biopsy was performed on 18 cases of patients with HPV L1 protein(+),results showed that 14 cases with positive result.Among 1360 cases with LCT and HPV L1 protein detection(-),497 cases accepted the patho-logical biopsy,and the results showed that 1 case presented(+),accounting for 0.2%.Totally 545 cases accepted the patholog-ical biopsy,among whom,38 cases presented(+),accounting for 6.97%;(3)Sensitivity and specificity of LCT combined with HPV L1 protein detection were higher than single-method detection,and difference had statistical significance(P <0.05).Con-clusion:Liquid based cytology test combined with HPV L1 protein detection could improve the diagnostic rate of cervical le-sions,and is expected effective method in the early clinical screening of cervical neoplasia lesions.%目的：：探讨液基细胞学制片技术对诊断子宫颈病变的价值,评价人乳头瘤病毒 L1(HPV L1)在子宫颈不同病变脱落细胞中的表达差异及意义.方法：将河北省廊坊市第四人民医院2009年1月~2013年8月1400例妇科门诊就诊妇女纳入研究,对所有入组人员进行液基细胞学(LCT)检查及脱落细胞中 HPV L1蛋白的表达检测,同时将宫颈活检病理学结果做为基线进行比较参照.结果：(1)1400例受检妇女中,LCT(＋)30例,占2．1％,HPV L1蛋白检测(＋)18例,占1．29％；LCT 及 HPV L1蛋白检测均(＋)8例,LCT 及 HPV L1蛋白检测均(－)1360例.(2)将 LCT 检测结果呈现(＋)的30例妇女进行病理组织活检,结果呈现(＋)为23例,将 HPV L1蛋白检测结果呈现(＋)18例妇女进行病理组织活检,结果呈现(＋)为14例,LCT 及 HPV L1蛋白检测均(－)1360例中有497例妇女自愿接受病理活检,结果显示1例妇女呈现(＋),占0．2％.共545例妇女接受病理活检,其中38例呈现(＋),比例为6．97％；(3)LCT 和 HPV L1蛋白两种方法联合检测的灵敏度及特异度均高于单一方法的检测(P ＜0．05).结论：液基细胞学联合 HPV L1蛋白检测可提高宫颈病变的诊断率,有望作为临床早期筛查宫颈瘤变的有效方法.