薄层液基细胞学联合HPV-DNA检测在粤东地区宫颈癌筛查中的临床价值

doi:10.3969/j.issn.1004-616x.2016.04.007

癌变·畸变·突变 ›› 2016, Vol. 28 ›› Issue (4): 281-283,291.doi: 10.3969/j.issn.1004-616x.2016.04.007

薄层液基细胞学联合HPV-DNA检测在粤东地区宫颈癌筛查中的临床价值

栗丽¹, 胡桂英², 吴宇丹¹, 沈伶¹

1. 汕头大学医学院第一附属医院, 广东汕头 515041, 2. 广东省妇幼保健院, 广东广州 510010

收稿日期:2016-02-29 修回日期:2016-05-11 出版日期:2016-07-31 发布日期:2016-07-31
通讯作者: 沈伶,E-mail:shenling0627@sina.com E-mail:shenling0627@sina.com
作者简介:栗丽,E-mai:lili780929@163.com
基金资助:
汕头市科技局项目[2015]

Clinical value of combining the thinprip cytologic test with HPV-DNA genotyping for cervical cancer screening in East Guangdong, China

LI Li¹, HU Guiying², WU Yudan¹, SHEN Ling¹

1. The First Affiliated Hospital of Shantou University Medical College, Shantou 515041;
2. Maternity and Child Health Hospital of Guangdong Province, Guangzhou 510010, China

Received:2016-02-29 Revised:2016-05-11 Online:2016-07-31 Published:2016-07-31

摘要/Abstract

摘要： 目的：评价薄层液基细胞学（TCT）联合HPV-DNA检测在粤东地区宫颈癌筛查中的临床价值。方法：分别应用TCT及HPV-DNA检测对2011年3月-2015年3月就诊的1681例粤东地区患者宫颈癌及癌前病变进行筛查并与宫颈活检组织对比。结果：TCT筛查结果显示阳性为399例，占23.7%（399/1681）；HPV-DNA共检出阳性患者533例，阳性率为31.7%（533/1681）。随着宫颈病变的发展，HPV-DNA检测阳性率明显增加（P<0.05）；病理组织诊断结果阳性例数267例，且在TCT检测阳性结果中，意义不明的不典型鳞状细胞（ASCUS）、低度鳞状上皮内病变（LSIL）、高度鳞状上皮内病变（HSIL）和鳞状细胞癌（SCC）与病理诊断阳性的一致性分别为46.8%、59.8%、96.3%和100%。TCT联合HPV-DNA筛查结果对宫颈癌筛查的敏感性（93.5%）、特异性（82.8%）及准确性（92.1%）均较单一筛查显著提高（P<0.05）。结论：TCT联合HPV-DNA检测可提高宫颈癌前病变的诊断准确率，更适用于宫颈癌前病变的筛查，值得临床推广应用。

关键词: 薄层液基细胞学, HPV-DNA分型, 宫颈癌筛查, 临床价值

Abstract: OBJECTIVE: To evaluate the clinical value of combining the thinprip cytologic test (TCT) with HPV-DNA genotyping for detecting cervical cancer in Eastern Guangdong region, China. METHODS: From March 2011-March 2014, 1 681 females were screened for cervical cancer. All patients underwent TCT and HPV-DNA screening, and cervical biopsies were evaluated for confirmation. RESULTS: Among the 1 681 cases, 399 were TCT positive, with the positive rate of 23.7%;533 cases were HPV-DNA positive, with the positive rate of 31.7%. Along with the development of cervical lesions, the positive rate of HPV-DNA was also increased (P<0.05);267 cases were rated positive based on pathological evaluation. And among the TCT positive patients, the consistency between ASCUS, LSIL, HSIL, SCC and positive diagnosis were 46.8%, 59.8%, 96.3% and 100% respectively. The sensitivity (93.5%), specificity (82.8%) and veracity (92.1%) values for TCT in combination with HPV-DNA screening were significantly greater than the results from individual screening assays (P<0.05). CONCLUSION: The combined HPV and TCT tests can significantly increase the accuracy rate of diagnosis for cervical precancerous lesions, therefore the tests can be considered for clinical applications.

Key words: thinprip cytologic test, HPV-DNA typing, cervical cancer screening, clinical value

中图分类号:

R711

栗丽, 胡桂英, 吴宇丹, 沈伶. 薄层液基细胞学联合HPV-DNA检测在粤东地区宫颈癌筛查中的临床价值[J]. 癌变·畸变·突变, 2016, 28(4): 281-283,291.

LI Li, HU Guiying, WU Yudan, SHEN Ling. Clinical value of combining the thinprip cytologic test with HPV-DNA genotyping for cervical cancer screening in East Guangdong, China[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2016, 28(4): 281-283,291.

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薄层液基细胞学联合HPV-DNA检测在粤东地区宫颈癌筛查中的临床价值

Clinical value of combining the thinprip cytologic test with HPV-DNA genotyping for cervical cancer screening in East Guangdong, China

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