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目的探讨薄层液基细胞学(TCT)检查联合HPV亚型检测在子宫颈上皮内瘤变(CIN)诊疗中的价值。方法随机选取扬州大学医学院附属六合医院2013年1月至2016年1月确诊为HPV阳性患者200例。对患者行TCT及组织病理学检查,以组织病理学结果将其分为宫颈炎104例(对照组)和CIN 96例(实验组:CINⅠ23例,CINⅡ32例,CINⅢ41例),CIN患者治疗后6月对实验组行阴道残端脱落细胞TCT检查联合HPV亚型检测。结果高危亚型HPV感染在不同分级的CIN患者中感染率显著高于低危亚型HPV感染,差异有统计学意义(P<0.05);随着病变加重,TCT异常率明显升高,实验组TCT异常率与对照组患者TCT异常率对比差异有统计学意义(P<0.05)。对CIN患者术后6个月随访发现,CIN患者有较高的HPV亚型转阴率,CINⅠ、CINⅡ、CINⅢ期的转阴率分别为100.0%、87.5%、80.5%。结论 TCT联合HPV亚型检测可以提高CIN检出率,CIN治疗后HPV亚型转阴率较高,可有效预防宫颈癌。
Objective To investigate the value of TLCT combined with HPV subtype detection in diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods 200 cases of HPV-positive patients were randomly selected from Liuhe Hospital Affiliated to Medical College of Yangzhou University from January 2013 to January 2016. TCT and histopathological examination were performed on the patients. The histopathological results were divided into 104 cases of cervicitis (control group) and 96 cases of CIN (experimental group: 23 cases of CINⅠ, 32 cases of CINⅡ and 41 cases of CINⅢ) Month on the experimental group of vaginal stump exfoliated cells TCT combined with HPV subtypes. Results The infection rate of high-risk subtype HPV in patients with different grades of CIN was significantly higher than that of the low-risk subtype HPV (P <0.05). The abnormal rate of TCT increased with the increase of disease, There was significant difference between TCT abnormal rate and TCT abnormal rate in control group (P <0.05). The 6-month follow-up of CIN patients showed that patients with CIN had a higher negative rate of HPV subtypes. The negative conversion rates of CINⅠ, CINⅡ and CINⅢ were 100.0%, 87.5% and 80.5% respectively. Conclusion TCT combined with HPV subtypes detection can improve the detection rate of CIN, CIN treatment of HPV subtypes after the negative rate is higher, which can effectively prevent cervical cancer.