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1、液基细胞学检查联合高危型HPV检测在宫颈癌筛查中临床应用doi：10.3969/j.issn.1007-614x.2014.12.74摘要目的：探讨液基细胞学(TCT)检查联合高危型人乳头瘤病毒(HC-IIHPV-DNA)检测在宫颈癌筛查中的临床意义。方法：2012年1月-2013年8月收集自愿接受宫颈癌筛查的妇女568例，行TCT检查，其中66例结果为不典型鳞形细胞(ASCUS)及以上，患者同时行高危型HPV检测和阴道镜检查并活检，分析两种方法对诊断宫颈病变的临床意义。结果：TCT检查结果异常ASCUS30
2、例，低度鳞状上皮内瘤变(LSIL)21例，高度鳞状上皮内瘤变(HSIL)13例，鳞状上皮细胞癌(SSC)2例。细胞学与病理诊断符合率为LSIL73.3%(22/30),HSIL92.3%(12/13),SCC100%(2/2)。高危型HPV感染率51.51%(34/66),高危型HPV在不同宫颈病变中的阳性率为ASC-US26.66%(8/30),LSIL66.66%(14/21),HSIL76.92%(10/13),SCC100.00%(2/2)o高危型HPV阳性率随宫颈病变程度加重而明显升高。TCT检查的
3、敏感性81.53%,特异性91.73%；HC-IIHPV-DNA检测的敏感性92.43%,特异性95.69%o结论：TCT结合HC-IIHPV-DNA检测增加了宫颈病变诊断的敏感性和特异性，提高了宫颈癌筛查的准确性。关键词TCT高危型HPV宫颈癌筛查ClinicalapplicationofliquidbasedcytologycombinedwithhighriskHPVtestingincervicalcancerscreeningHanYanmin,DengYaTheTenthPeople，sHospi
4、talofZhengzhouCity,Henan450052AbstractObjective:Todiscusstheclinicalsignificanceofliquidbasedcytology(TCT)combinedwithhighriskhumanpapillomavirus(HCTIHPV-DNA)detectionincervicalcancerscreening.Methods:568casesofvoluntarywomenwithcervicalcancerscreeningweres
5、electedfromJanuary2012toAugust2013.TheyweregivenTCTexamination.Theresultsof66caseswereatypicalsquamouscell(ASCUS)andabove・ThepatientswerealsogivenhighriskHPVtestingandcolposcopyandbiopsy.Theclinicalsignificanceof2methodsinthediagnosisofcervicallesionswerean
6、alyzed.Results：AbnormalTCTresuItsshowedASCUSin30cases,lowgradesquamousintraepithelialneoplasia(LSIL)in21cases,high-gradesquamousintraepithelialneoplasia(HSIL)in13cases,squamouscellcarcinoma(SSC)in2cases・Cytologicalandpathologicaldiagnosiscoincidencerateshow
7、edthatLSILwas73.3%(22/30),IISILwas92.3%(12/13),SCCwas100%(2/2).Theinfectionrateofhigh-risktypeHPVwas51.51%(34/66).ThepositiverateofhighrisktypeHPVindifferentcervicallesions：ASC-USwas26.66%(8/30),LSILwas66.66%(14/21),HSILwas76.92%(10/13),SCCwas100%(2/2).Thep
8、ositiverateofhighrisktypeHPVincreasedsignificantlywiththeaggravatingdegreeofcervicallesions.ThesensitivityofTCTexaminationswas81.53%,thespecificitywas91.73%.ThesensitivityofHC-IIHPV-DNAdetectionwas92.4
