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目的:探讨高危型人乳头瘤病毒(HPV)检测和宫颈液基细胞学检查(TCT)在宫颈上皮内瘤变(CIN)诊断中的临床价值。方法:分析142例行高危型HPV检测和TCT检查,同时行阴道镜定位活检并有病理结果患者的临床资料。结果:142例患者中HPV阳性57例,阳性率40.14%。病理诊断为慢性宫颈炎79例,HPV感染率为10.13%,CIN63例,其中CINⅠ38例、CINⅡ14例、CINⅢ11例,HPV感染率分别为71.05%、85.71%、90.91%,随着宫颈病变程度加重,HPV感染率随之上升,CINⅠ～Ⅲ与慢性宫颈炎的HPV感染率差异有统计学意义。TCT检测,异常涂片72例,其中ASC37例,CINⅡ检出3例(8.11%),无CINⅢ检出;LSIL23例,CINⅡ、CINⅢ检出共10例(43.47%);HSIL12例,CINⅡ、CINⅢ检出共11例(91.67%),随着细胞学异常级别的升高,宫颈高度病变(CINⅡ、CINⅢ)检出率显著增加。病理学、细胞学、HPV检测同时比较,TCT和HPV均阴性的患者中,无1例CINⅡ以上的病例。结论:高危型HPV与宫颈癌及CIN的发生有关,高危型HPV联合TCT检测,用于宫颈病变筛查漏诊率低,若再有针对性地行阴道镜检查、定位活检,可早期、准确诊断宫颈癌前病变。
Objective: To investigate the clinical value of high risk human papilloma virus (HPV) test and cervical liquid cell cytology (TCT) in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods: The clinical data of 142 patients with high-risk HPV test and TCT examination and colposcopic biopsy with pathological results were analyzed. Results: Among the 142 patients, 57 were positive for HPV, the positive rate was 40.14%. Pathological diagnosis of chronic cervicitis in 79 cases, the rate of HPV infection was 10.13%, 63 cases of CIN, including CINⅠ38 cases, CINⅡ14 cases, CINⅢ11 cases, HPV infection rates were 71.05%, 85.71%, 90.91%, with the severity of cervical lesions, HPV infection rate increased, the difference between CINⅠ ~ Ⅲ and chronic cervicitis HPV infection was statistically significant. There were 72 cases with TCT and abnormal smear, of which 37 cases were ASC, 3 cases (8.11%) were detected by CINⅡ and no CINⅢ was detected. In 23 cases of LSIL, 10 cases (43.47%) were detected by CINⅡ and CINⅢ; A total of 11 cases (91.67%) were detected. With the increase of cytological abnormalities, the detection rate of cervical hyperplastic lesions (CINⅡ, CINⅢ) increased significantly. Pathology, cytology, HPV testing at the same time, TCT and HPV were negative in patients, no more than one case of CIN Ⅱ. Conclusion: High-risk HPV is associated with the occurrence of cervical cancer and CIN. High-risk HPV combined with TCT detection is low for misdiagnosis of cervical lesions. If colposcopy and biopsy are targeted, it can be diagnosed early and accurately Cervical precancerous lesions.