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液基薄层细胞学技术联合高危型人乳头瘤病毒检测在宫颈癌筛查中的临床应用研究 预览

Research of clinical application of thinprep cytologic test combined with high-risk human papilloma virus detection in cervical cancer screening
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摘要 目的研究高危型人乳头瘤病毒(HR-HPV)检测与液基薄层细胞学技术(TCT)在宫颈癌前病变中的临床运用效果,对比分析其敏感性及特异性。方法 350例宫颈癌病理筛查阳性者分别采用TCT与HR-HPV检测进行筛查,对筛查阳性患者6个月1次采用TCT与HR-HPV联合检测进行跟踪测定,持续3年,分析研究HPV-脱氧核糖核酸(DNA)载量与疾病进程的关联性,并与病理诊断结果比较,讨论两者对疾病检测的敏感性及特异性。结果 350例筛查阳性患者中,其中HR-HPV筛查阳性328例,阳性率93.7%(328/350),TCT筛查阳性234例,阳性率66.9%(234/350),比较差异有统计学意义(P〈0.05)。328例HR-HPV阳性患者中,与病理检查结果宫颈上皮内瘤变(CIN)Ⅱ级以上者相符合为126例,敏感性为89.6%、特异性为38.4%;234例TCT筛查阳性患者中,与病理结果符合者190例,敏感性为68.6%、特异性为81.2%,两项检测特异性、敏感性比较差异有统计学意义(P〈0.05)。经过追踪检测发现,宫颈病变CINⅠ级或以上病例病灶复发/残留与病毒载量有一定关联性,宫颈病变CIN分级越高,与病毒载量相关性越高(P〈0.05)。结论 TCT技术和HR-HPV检测方法各有优势,HR-HPV联合TCT技术可以有效提高宫颈癌检出效率,能够弥补单一检测方法的不足;HR-HPV检测可以作为病程监控的敏感指标;将TCT与HR-HPV联合检查,值得推荐。 Objective To research clinical application effect by high-risk human papilloma virus(HRHPV) detection and thinprep cytologic test(TCT) in precancerous lesions of uterine cervix, and to analyze their sensibility and specificity. Methods A total of 350 patients with positive pathological screening of cervical cancer all received TCT and HR-HPV detection for screening. Combination of TCT and HR-HPV detection as applied once per 6 months for monitoring detection in patients for 3 years. Analysis was made on correlation between HPV-desoxyribonucleic acid(DNA) capacity and disease progress. Comparing with pathological diagnosis outcomes, their sensibility and specificity in disease detection were discussed. Results Among the 350 patients with positive screening outcomes, there were 328 positive cases in positive HR-HPV screening, with positive rate as 93.7%(328/350), and 234 positive cases in TCT screening, with positive rate as 66.9%(324/350). Their difference had statistical significance(P〈0.05). Among 328 positive cases in positive HR-HPV screening, there were 126 corresponding cases with pathological detection over Cervical intraepithelial neoplasias(CIN) Ⅱ grade, with sensibility as 89.6% and specificity as 38.4%. Among 234 positive cases in TCT screening, there were 190 corresponding cases with pathological detection, with sensibility as 68.6% and specificity as 81.2%. The difference of sensibility and specificity had statistical significance between the two detection measures(P〈0.05). Monitoring detection showed certain correlation between lesions recurrencel residual and viral capacity in cases with over cervical lesion CIN Ⅰ grade, and higher cervical lesion CIN grade led to close correlation with viral capacity(P〈0.05). Conclusion Both TCT and HR-HPV detection contain their own advantages. Combination of HR-HPV and TCT can effectively improve detection efficiency of cervical cancer and cover shortages of single detection method. HRHPV detection can be taken as the
作者 李光梅 冼志霞 邓舒静 LI Guang-mei, XIAN Zhi-xia, DENG Shu-jing. (Guangdong Wuchuan City Maternal and Child Health Hospital, Wuchuan 524500, China)
出处 《中国实用医药》 2017年第2期34-36,共3页 China Practical Medical
关键词 宫颈癌 高危型人乳头瘤病毒 液基薄层细胞学技术 Cervical cancer High-risk human papilloma virus Thinprep cytologic test
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