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目的:探讨16/18型人乳头瘤病毒DNA原位杂交技术在液基薄层细胞学(LCT)诊断非典型鳞状细胞宫颈疾病中的应用价值。方法:选取2013年6月~2014年7月该院妇科门诊患者7 360例,对所有患者进行LCT检测,对细胞学结果意义不明确(ASC-US)及以上者行液基细胞16/18型HPV-DNA原位杂交检测,同时进行阴道镜活检。以组织病理学结果为金标准,比较LCT检测与16/18型HPV-DNA原位杂交技术单独及联合应用在宫颈病变中的诊断价值。结果:LCT检测结果ASC-US及以上患者536例(7.3%);536例宫颈活检组织病理学结果阴性(NILM)145例(27.1%)、低度鳞状上皮内病变(LSIL)312例(58.2%)、高度鳞状上皮内病变(HSIL)67例(12.5%)、鳞癌+腺癌12例(2.2%),其原位杂交阳性率分别为8.9%、51.0%、88.1%、91.7%;LCT、原位杂交单独及两者联合对HSIL筛查的敏感性分别为60.8%、88.6%、97.5%;特异性分别为97.8%、62.4%、61.7%,阴性预测值分别为93.5%、96.9%、99.3%。结论:LCT、16/18型HPV-DNA液基原位杂交技术均是有效的宫颈癌前病变及宫颈癌筛查方法,两者联合应用可实现一次取材两项检测的目的,并可提高筛查的敏感性和阴性预测值。
Objective: To investigate the value of 16/18 human papillomavirus DNA in situ hybridization in the diagnosis of atypical squamous cell cervical disease by liquid-based thin-section cytology (LCT). Methods: A total of 7 360 gynecological outpatients from June 2013 to July 2014 were selected. LCT was performed on all the patients. The cytological results were not clear (ASC-US) and above, and liquid-based cells 16/18 Type HPV-DNA in situ hybridization, colposcopic biopsy. Histopathological results as the gold standard, comparing the diagnostic value of LCT and 16/18 HPV-DNA in situ hybridization alone and in combination in the diagnosis of cervical lesions. RESULTS: The LCT results were 536 (7.3%) in patients with ASC-US and above, 145 (27.1%) were negative in 536 cervical biopsy specimens, and 312 were in low grade squamous intraepithelial lesions (LSIL) The positive rates of in situ hybridization were 67%, 51.0%, 88.1%, 91.7%, respectively. The positive rates of HSIL in 67 cases (12.5%) and squamous cell carcinoma + adenocarcinoma in 12 cases %, Respectively. The sensitivity of LCT, in situ hybridization alone and the combination of the two was 60.8%, 88.6%, 97.5% respectively, and the specificity was 97.8%, 62.4%, 61.7%, respectively. The negative predictive values were 93.5% , 96.9%, 99.3%. Conclusion: LCT and 16/18 HPV-DNA liquid-based in situ hybridization are both effective cervical precancerous lesions and cervical cancer screening methods, and the combination of the two can achieve the purpose of obtaining two samples at a time and improve the screening Check the sensitivity and negative predictive value.