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目的探讨液基薄层细胞检测(TCT)结合高危型人乳头瘤病毒(HPV)体检筛查在宫颈上皮内瘤变及宫颈癌防治过程中的作用。方法 2009年7月—2010年7月濮阳市油田总医院门诊接受宫颈癌筛查的763名妇女分别进行高危型HPV及TCT检查,任何一项或两项同时阳性患者均行阴道镜下多点活检病理学检查。比较三种检查方法阳性病例与病理检查结果符合率。结果 763名妇女中,高危型HPV检出阳性287例,占37.6%,经病理学检查阳性82例,阳性符合率为28.6%;TCT检出阳性78例,占10.2%,病理检查阳性50例,阳性符合率64.1%;高危型HPV加TCT检出两者均阳性129例,与病理检查结果阳性符合率为97.7%,各组之间阳性符合率比较,差异有显统计学意义(P<0.05);高危型HPV在不同宫颈病变中的阳性率分别为宫颈癌前病变(CIN)Ⅰ23.33%(14/60)、CINⅡ42.85%(15/35)、CINⅢ50%(15/30)、SCC 85.7%(6/7)。结论随着宫颈病变级别的升高,高危型HPV-DNA的阳性率显著上升;高危型HPV-联合TCT检查可提高宫颈上皮内瘤变及宫颈癌检出率,为宫颈癌的早期诊断提供参考。
Objective To investigate the role of TCT combined with high-risk human papillomavirus (HPV) screening in the prevention and treatment of cervical intraepithelial neoplasia and cervical cancer. Methods From July 2009 to July 2010, 763 women who underwent screening for cervical cancer in Puyang Oilfield General Hospital were examined by high-risk HPV and TCT respectively. Any one or two concurrent positive patients underwent multiple colposcopy Biopsy pathology. Comparing the positive rate of the three test methods with the pathological examination results. Results Of the 763 women, high-risk HPVs were detected in 287 cases (37.6%) and 82 (68.6%) by pathology. The positive coincidence rate was 28.6%. TCT was positive in 78 cases (10.2%) and pathological examination was positive in 50 cases , And the positive coincidence rate was 64.1%. High-risk HPV plus TCT was detected in both 129 positive cases and 97.7% positive cases in pathological examination. The positive coincidence rates among the groups were statistically significant (P < 0.05). The positive rates of high-risk HPV in different cervical lesions were 23.33% (14/60), 42.85% (15/35) and 50% (15/30) in cervical precancerous lesions (CIN) , SCC 85.7% (6/7). Conclusions The positive rate of high-risk HPV-DNA increases with the increase of cervical lesions. High-risk HPV-combined TCT can improve the detection rate of cervical intraepithelial neoplasia and cervical cancer and provide a reference for the early diagnosis of cervical cancer .