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目的:探讨高危型HPV检测联合细胞学检查在宫颈病变中的意义,为预防宫颈癌的发生及早期诊断与治疗提供进一步的指导依据。方法:该院2008年1月～2011年1月门诊自愿接受宫颈癌筛查的妇女2 697例,分别进行HR-HPV-DNA、TCT、HR-HPV-DNA+TCT检查,阳性病例均进行阴道镜活检。结果:2 697例进行筛查的妇女中标本发现异常涂片266例,占9.86%,其中意义不明的不典型鳞状细胞(ASCUS)170例,占6.30%,低度鳞状上皮内病变(LSIL)74例,占2.74%,高度鳞状上皮内病变(HSIL)72例,占2.67%,鳞状细胞癌(SCC)8例,占0.30%。266例TCT检测细胞学异常(ASCUS及以上)标本中高危型HPV阳性162例,HPV感染率60.90%。不同类型标本高危型HPV感染情况结果显示:ASCUS、LSIL、HSIL各组间的HPV感染率有统计学差异(P<0.01)。结论:将高危型HPV检测与TCT检测技术相结合应用于早期宫颈癌及癌前病变筛查中,提高了筛查宫颈病变的准确性。
Objective: To explore the significance of high-risk HPV testing combined with cytological examination in cervical lesions and to provide further guidance for preventing the occurrence and early diagnosis and treatment of cervical cancer. Methods: A total of 2 697 women were screened for cervical cancer from January 2008 to January 2011 in our hospital. The patients were examined by HR-HPV-DNA, TCT, HR-HPV-DNA and TCT respectively. Biopsy. Results: A total of 266 cases (9.86%) were found in 2 697 women who had been screened for abnormal smears. Among them, 170 cases of atypical squamous cell carcinoma of unknown significance (ASCUS) accounted for 6.30%, low grade squamous intraepithelial lesion There were 74 cases (2.74%) of LSIL, 72 cases of high grade squamous intraepithelial lesion (HSIL), accounting for 2.67% and 8 cases of squamous cell carcinoma (SCC) accounting for 0.30%. Among 266 cases of TCT cytology abnormalities (ASCUS and above), 162 cases were positive for high-risk HPV, and the HPV infection rate was 60.90%. The results of high-risk HPV infection in different types of specimens showed that HPV infection rates among ASCUS, LSIL and HSIL groups were statistically different (P <0.01). Conclusion: The combination of high-risk HPV testing and TCT detection technology can be used to screen early cervical cancer and precancerous lesions and improve the accuracy of screening cervical lesions.