液基薄层细胞学检测联合高危型人乳头瘤病毒检测对宫颈癌前病变的诊断价值探讨

摘要

Objective This study was designed to investigate the diagnostic value of liquid-based thin-layer cytology (LCT) combined with high-risk human papillomavirus (HR-HPV) in cervical precancerous lesions. Method Cervical ex-foliative cells from 4009 patients were examined with LCT combined with HR-HPV for genotyping, and then were com-pared with the pathological diagnosis of cervical tissues to explore the sensitivity and specificity of the two cervical can-cer screening methods. Result The positive rate of HPV, LCT, and the combined detection of both in women under 21 years of age was significantly higher than that in those aged 21~29, 30~65, and>65 years-old. In this study, of the 2716 cases aged 30~65 years-old, cervical histopathological abnormalities were observed in 158 cases, of which HR-HPV posi-tive accounted for 81.6% (129/158); cervical cytology abnormalities accounted for 55.7% (88/158); positive results of LCT combined with HR-HPV accounted for 88.0%(139/158). The sensitivity and specificity of LCT combined with HR-HPV detection were higher than that of LCT or HR-HPV alone. Conclusion The sensitivity and specificity of LCT com-bined with HR-HPV were significantly higher than that of LCT or HR-HPV alone in cervical cancer screening, and may detect the missed lesions when using LCT or HR-HPV alone, thus decreasing the morbidity and mortality of precancerous lesions and cervical cancer, and it is clinically applicable.%目的 本研究旨在探讨液基薄层细胞学(LCT)检测联合高危型人乳头瘤病毒(HR-HPV)检测对宫颈癌前病变的诊断价值.方法 对门诊进行宫颈癌筛查的4009例患者的宫颈脱落细胞采用LCT联合HR-HPV基因分型,然后与宫颈组织病理学诊断结果进行比较分析,探讨这两种宫颈癌筛查方法的灵敏度和特异度.结果低于21岁的女性受试者的HPV、LCT以及两者联合检测的阳性率明显高于21~29岁、30~65岁、﹥65岁的女性受试者.本研究2716例30~65岁女性人群中,宫颈组织病理学异常者158例,其中HR-HPV阳性者占81.6%(129/158);宫颈细胞学异常者占55.7%(88/158);LCT联合HR-HPV阳性者占88.0%(139/158).LCT联合HR-HPV检测的灵敏度和特异度高于单独的LCT检测或者HR-HPV检测.结论 在宫颈癌筛查中,LCT联合HR-HPV检测的灵敏度和特异度高于单独的LCT检测或者HR-HPV检测,可发现LCT或者HR-HPV漏诊的宫颈组织病变,从而降低癌前病变及宫颈癌的发生率和死亡率,值得在临床大力推广应用.