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目的探讨液基薄层细胞学技术(TCT)联合高危型人乳头瘤病毒(HPV)-DNA检测在宫颈病变筛查中的应用价值。方法 2009年7月至2012年3月行TCT及HPV检查共6815例,对其中TCT阳性及(或)HPV阳性者共757例在电子阴道镜下予宫颈活检术,对照TCT、HPV与病检结果,进行回顾性分析。结果 (1)HSIL及SCC与病理组织学诊断有较高的符合率,而ASCUS、LSIL、ASC-H与病理组织学诊断符合率较低。(2)HPV阳性率随着细胞学及CIN级别增高而增高;病理学≥CINⅡ者HPV均为阳性。(3)ASCUS病例中HPV阳性与阴性组者与病理组织学结果的符合率有明显差异;而ASC-H病例中,病检为CINⅡ以上者占78.4%。结论 (1)TCT和HPV-DNA检查均为宫颈病变的筛查方法,二者结合有利于宫颈病变的早期发现,可提高宫颈癌及癌前病变的检出率。(2)对TCT结果为ASCUS者,HPV检测可起到良好的分流作用;而对于ASC-H,须及时行阴道镜检查并取活检以明确诊断。
Objective To investigate the value of liquid-based cytology (TCT) combined with high-risk human papillomavirus (HPV) -DNA in the screening of cervical lesions. Methods From July 2009 to March 2012, a total of 6,815 TCT and HPV tests were performed. Among them, 757 cases of TCT positive and / or HPV positive were examined by electronic colposcopy and compared with TCT, HPV and disease examination Results, a retrospective analysis. Results (1) HSIL and SCC had a higher coincidence rate with histopathological diagnosis, while ASCUS, LSIL and ASC-H had a lower coincidence rate with histopathological diagnosis. (2) The positive rate of HPV increased with the increase of cytology and CIN level, and the positive rate of pathology≥CINII was HPV. (3) There was a significant difference between the coincidence rates of pathological and histopathological results in HPV-positive and -negative patients in ASCUS cases, while in ASC-H cases, the prevalence of CINⅡwas 78.4% in ASC-H cases. Conclusions (1) Both TCT and HPV-DNA examination are screening methods for cervical lesions. The combination of the two can be helpful for the early detection of cervical lesions and can improve the detection rate of cervical cancer and precancerous lesions. (2) For ASCUS with TCT, HPV test can play a good role in shunting. For ASC-H, colposcopy and biopsy should be done in time to confirm the diagnosis.