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目的应用多重PCR扩增和多重分子杂交结合的液态基因芯片法检测25种亚型HPV感染,联合液基细胞学TCT方法对宫颈病变进行筛查,评价其联合筛查效果。方法收集2010年3月～2011年3月于首都医科大学附属北京妇产医院就诊,TCT检查异常患者313例,同时行液态基因芯片法HPV分型检测,并行宫颈活检病理学诊断作为诊断金标准。结果细胞学TCT对CIN及宫颈癌筛查的敏感度为(173/233)74.2%,单独HPV检测为84.5(197/233)%,TCT联合HPV分型检测为(211/233)90.6%。TCT诊断为ASCUS的101例患者,病理诊断慢性炎症41例(40.59%)、CINⅠ41例(40.59%)、CINⅡ11例(10.89%)、CINⅢ6例(5.94%)、鳞癌2例(1.98%)。HPV分型检测阳性率为67.33%(68/101)。结论 TCT检查联合基因芯片法HPV检测对宫颈病变具有较好的检出效果,需重视细胞学提示ASCUS患者,应进一步检查及加强随访。
Objective To detect 25 subtypes of HPV infection by liquid microarray combined with multiplex PCR and multiplex liquid hybridization (LCM-MS), and to screen cervical lesions by liquid-based cytology (TCT). Methods A total of 313 patients with abnormal TCT were examined at March 2010 March and March 2011 at Beijing Maternity Hospital Affiliated to Capital Medical University. At the same time, HPV genotyping was performed by liquid gene microarray, and pathological diagnosis of cervical biopsy was taken as the gold standard for diagnosis . Results Cytology TCT showed a sensitivity of (173/233) 74.2% for CIN and cervical cancer screening, 84.5 (197/233)% for HPV alone, and 90.6% for TCT combined with HPV (211/233). There were 41 cases (40.59%) with pathological diagnosis of chronic inflammation, 41 cases (40.59%) with CINⅠ, 11 cases (10.89%) with CINⅡ, 6 cases with CINⅢ (5.94%) and 2 cases with squamous cell carcinoma (1.98%) with TCT diagnosed as ASCUS. The positive rate of HPV typing was 67.33% (68/101). Conclusion TCT combined with gene chip HPV test has a good detection of cervical lesions, cytology should be emphasized that ASCUS patients should be further examined and enhanced follow-up.