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目的探讨液基薄层细胞学检测(TCT)、人乳头瘤病毒核酸检测(HPV-PCR)及阴道镜下宫颈组织活检对宫颈疾病筛查的应用实效性。方法选取温州医科大学附属第一医院2013年4月至2014年4月接受宫颈癌筛查的体检患者共701名,采取TCT、HPV-PCR及阴道镜检查方式,观察3种检测方法的效果。结果经过TCT检验后,非典型鳞状上皮细胞(ASCUS)、ASCUS-H、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、鳞癌(SCC)的阳性率分别为12.82%、26.92%、64.29%、100.00%、100.00%。142例患者经过HPV-DNA荧光定量PCR分析后,炎症反应中,6/11亚型和16/18亚型的阳性率分别为10.71%和3.57%(χ2=5.349,P<0.05);ASCUS(包括ASCUS-H)6/11亚型和16/18亚型阳性率分别为10.00%和5.00%(χ2=4.291,P<0.05);CIN I中,6/11亚型的感染率为35.48%,16/18亚型的感染率为9.68%(χ2=7.631,P<0.05)。患者经过TCT技术检查后,在ASCUS和LSIL患者中第1次组织活检时出现漏检,漏诊率分别为6.45%和20.00%。结论 TCT、HPV-PCR及阴道镜下均为子宫颈病变早期诊断的较好选择,各有优势。
Objective To investigate the practical effects of TCT, HPV-PCR and colposcopic cervical biopsy on cervical disease screening. Methods A total of 701 physical examination patients who underwent cervical cancer screening from April 2013 to April 2014 were selected from the First Affiliated Hospital of Wenzhou Medical University. The effects of the three detection methods were observed by TCT, HPV-PCR and colposcopy. Results After TCT test, the positive rates of ASCUS, ASCUS-H, LSIL, HSIL and SCC were Is 12.82%, 26.92%, 64.29%, 100.00%, 100.00%. The positive rates of 6/11 and 16/18 subtypes were 10.71% and 3.57% (χ2 = 5.349, P <0.05) respectively after 142 cases of HPV-DNA fluorescence quantitative PCR analysis. ASCUS ( Including the ASCUS-H) 6/11 subtype and 16/18 subtype positive rate was 10.00% and 5.00% (χ2 = 4.291, P <0.05); CIN I, 6/11 subtype infection rate was 35.48% The infection rate of 16/18 was 9.68% (χ2 = 7.631, P <0.05). After the TCT technique, patients underwent missed tests on the first biopsy in ASCUS and LSIL patients, with a missed diagnosis rate of 6.45% and 20.00%, respectively. Conclusion TCT, HPV-PCR and colposcopy are all the better choices for early diagnosis of cervical lesions, each with its own advantages.