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目的探讨宫颈液基细胞学(thin-prep cell test,TCT)联合高危型人乳头瘤病毒(human papilloma virus,HR-HPV)检测对宫颈病变诊断的意义。方法选取2010年3月—2011年10月就诊的妇女1 575名,随机均分为TCT组、HPV组、联合组,分别进行高危型HPV、TCT及HPV联合TCT检查,检查结果呈阳性的患者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的符合率。结果阳性符合率TCT组30.43%,HPV组31.90%,联合组97.54%,联合组明显高于HPV组与TCT组(均P<0.05)。在不同宫颈病变中高危型HPV的阳性率分别为宫颈上皮内瘤变(cervical intraepithelical neoplasia,CIN)Ⅰ18.00%、CINⅡ42.86%、CINⅢ49.12%、鳞状细胞癌(squamous cell carcinoma,SCC)75.00%。结论高危型HPV感染与宫颈病变严重程度密切相关,宫颈病变严重度越高,HPV感染的阳性率越高。高危型HPV检测联合TCT检查可提高宫颈病变检出率,为宫颈癌的早期诊断提供参考。
Objective To investigate the significance of cervical cytology-based cytology (TCT) combined with high-risk human papilloma virus (HR-HPV) in the diagnosis of cervical lesions. Methods A total of 1 575 women from March 2010 to October 2011 were selected and randomly divided into TCT group, HPV group and combined group. High-risk HPV, TCT and HPV combined with TCT were detected respectively. The patients with positive test results Colposcopy multipoint biopsy pathological examination. The coincidence rates of the three positive cases and the pathological findings were compared. Results The positive coincidence rate was 30.43% in TCT group, 31.90% in HPV group and 97.54% in combination group, which was significantly higher in combination group than in HPV group and TCT group (all P <0.05). The positive rates of high-risk HPV in different cervical lesions were 18.00% of cervical intraepithelial neoplasia (CIN), 42.86% of CINⅡ, 49.12% of CINⅢ, squamous cell carcinoma (SCC) ) 75.00%. Conclusion High-risk HPV infection is closely related to the severity of cervical lesions. The higher the severity of cervical lesions, the higher the positive rate of HPV infection. High-risk HPV testing combined with TCT examination can improve the detection rate of cervical lesions for early diagnosis of cervical cancer provide a reference.