【摘要】 目的评价薄层液基细胞学(Thinprep Cytology Test,TCT)与高危型人乳头瘤病毒(human papilloma-virus,HR-HPV)检测在宫颈上皮病变筛查中的应用价值。方法对广东省潮州市3723名农村妇女同时进行TCT检查和HR-HPV检测,阳性的妇女进行宫颈组织病理学检查,分析TCT与HR-HPV检测以及联合检查在宫颈上皮病变筛查中的应用价值。结果 78例农村妇女TCT检查阳性,其中鳞状细胞(ASC)15例(19.2%);低级别鳞状上皮病变(LSIL)44例(56.4%);高级别鳞状上皮病变(HSIL)19例(24.4%)。65例检测出HR-HPV阳性,阳性率为1.7%(65/3723)。94例患者宫颈组织病理诊断为炎症者19例(20.2%);宫颈上皮内瘤样病变(CIN)Ⅰ级39例(41.5%)、CINⅡ级15例(16.0%)、CINⅢ级20例(21.3%);鳞状细胞癌(SCC)1例(1.1%)。TCT对诊断宫颈癌与癌前病变的阳性预测值0.45,阴性预测值0.94;HR-HPV检测宫颈上皮病变的阳性预测值为0.52,阴性预测值为0.93。TCT联合HR-HPV检测宫颈上皮病变的阳性预测值为0.69(34/49),高于TCT的阳性预测值,差异有统计学意义(χ2=7.290,P=0.007),与HR-HPV阳性预测值差异无统计学意义(χ2=3.386,P=0.066)。结论 TCT与HR-HPV检测是宫颈上皮病变筛查的理想方法,两种方法联合应用可提高宫颈上皮病变的阳性预测值。更多还原

【Abstract】 Objective To analyze the difference the value of the ThinPrep cytology test(TCT) and high risk human papillomavirus(HR-HPV) testing in screening cervical epithelial lesions.Methods Specimens form 3723 women in Chaozhou city guangdong privence were tested by TCT and HR-HPV testing.The samples with TCT or HR HPV positive were examinated by histopathology of the cervical tissue.Furthermore,the effectiveness of TCT or HR-HPV testing and combining both were evaluated in cervical cancer screening.Results 78 cases were positive in TCT,ASC 15(19.2%) ;LSIL 44(56.4%) ;HSIL 19(20.2%).65 cases were positive in HR-HPV testing.Positive rate of HR HPV was 1.7%(65 /3723).Among 94 cases with histopathological diagnosis,19(20.2%) were inflammation,39(41.5%) CINⅠ,15(16.0%) CINⅡ,20(8.16%) CINⅢ,1(1.1%) SCC.The positive predictive value and negative predictive value were 0.45 and 0.94 respectly of TCT in cervical epithelial lesions screening,that were 0.52 and 0.93 in HR-HPV testing.The positive predictive value was 0.69 of TCT combined HR-HPV testing,which showed higher than TCT,and it was significant difference(χ2 = 7.290,P = 0.007),but was no difference with HR-HPV testing in screening of cervical epithelial lesions(χ2 = 3.386,P = 0.066).Conclusions TCT and HR-HPV testing are effective method in screening of cervical epithelial lesions.TCT combined HPV testing increase the positive predictive value in screening of cervical epithelial lesions.更多还原