中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
28期
23-24
,共2页
三阶梯%筛查%液基薄层细胞学%人乳头瘤病毒%宫颈上皮内瘤样病变
三階梯%篩查%液基薄層細胞學%人乳頭瘤病毒%宮頸上皮內瘤樣病變
삼계제%사사%액기박층세포학%인유두류병독%궁경상피내류양병변
Three-step%Screening%Thinprep cytology test%Human papilloma virus%Cervical intraepithelial neoplasia
目的：探讨液基薄层细胞学(TCT)检查及高危型人乳头瘤病毒(HPV)检测在宫颈癌初筛中的不同临床应用价值。方法对1092例25~57岁的妇女进行免费 TCT 及高危型 HPV 检测, TCT 检查诊断为不明确的非典型鳞状细胞(ASCUS)及以上者或高危型 HPV 检测为阳性者均进行阴道镜下活检并送病理。结果TCT 检查1092例受检者中, TCT 阳性236例,检出率21.61%,其中包括 ASCUS 126例、鳞状上皮低度病变(ISIL)34例、鳞状上皮高度病变(HSIL)74例、鳞状细胞癌(SCC)2例。ASCUS 中活检为宫颈上皮内瘤样病变(CIN)者58例,病理组织学符合率为46.03%；LSIL 中活检为 CIN 者24例,病理组织学符合率为70.59%；HSIL 中活检为 CIN 者66例,病理组织学符合率为89.19%；SCC 中活检为SCC 者2例,病理组织学符合率为100.00%。TCT 阳性者与病理组织学总符合率达63.56%。1092例受检者中, HPV 阳性者512例, 检出率为46.89%。其中病理活检为炎症者332例, 占 64.84%,病理活检为CIN Ⅰ级及以上者180例,占35.16%(其中 CIN Ⅰ级128例、CIN Ⅱ级30例、CIN Ⅲ级20例、SCC 2例)。与 TCT 检查的组织符合率(63.56%)相比,差异有统计学意义(χ2=52.86, P<0.05)。结论与 HPV 病毒检测相比, TCT 检测的组织学诊断符合率更高,特别是对于 TCT 检测结果为 HSIL 者；对于 TCT 检测结果为 ASCUS 者, HPV 病毒检测可以起到有效的分流管理作用。
目的：探討液基薄層細胞學(TCT)檢查及高危型人乳頭瘤病毒(HPV)檢測在宮頸癌初篩中的不同臨床應用價值。方法對1092例25~57歲的婦女進行免費 TCT 及高危型 HPV 檢測, TCT 檢查診斷為不明確的非典型鱗狀細胞(ASCUS)及以上者或高危型 HPV 檢測為暘性者均進行陰道鏡下活檢併送病理。結果TCT 檢查1092例受檢者中, TCT 暘性236例,檢齣率21.61%,其中包括 ASCUS 126例、鱗狀上皮低度病變(ISIL)34例、鱗狀上皮高度病變(HSIL)74例、鱗狀細胞癌(SCC)2例。ASCUS 中活檢為宮頸上皮內瘤樣病變(CIN)者58例,病理組織學符閤率為46.03%；LSIL 中活檢為 CIN 者24例,病理組織學符閤率為70.59%；HSIL 中活檢為 CIN 者66例,病理組織學符閤率為89.19%；SCC 中活檢為SCC 者2例,病理組織學符閤率為100.00%。TCT 暘性者與病理組織學總符閤率達63.56%。1092例受檢者中, HPV 暘性者512例, 檢齣率為46.89%。其中病理活檢為炎癥者332例, 佔 64.84%,病理活檢為CIN Ⅰ級及以上者180例,佔35.16%(其中 CIN Ⅰ級128例、CIN Ⅱ級30例、CIN Ⅲ級20例、SCC 2例)。與 TCT 檢查的組織符閤率(63.56%)相比,差異有統計學意義(χ2=52.86, P<0.05)。結論與 HPV 病毒檢測相比, TCT 檢測的組織學診斷符閤率更高,特彆是對于 TCT 檢測結果為 HSIL 者；對于 TCT 檢測結果為 ASCUS 者, HPV 病毒檢測可以起到有效的分流管理作用。
목적：탐토액기박층세포학(TCT)검사급고위형인유두류병독(HPV)검측재궁경암초사중적불동림상응용개치。방법대1092례25~57세적부녀진행면비 TCT 급고위형 HPV 검측, TCT 검사진단위불명학적비전형린상세포(ASCUS)급이상자혹고위형 HPV 검측위양성자균진행음도경하활검병송병리。결과TCT 검사1092례수검자중, TCT 양성236례,검출솔21.61%,기중포괄 ASCUS 126례、린상상피저도병변(ISIL)34례、린상상피고도병변(HSIL)74례、린상세포암(SCC)2례。ASCUS 중활검위궁경상피내류양병변(CIN)자58례,병리조직학부합솔위46.03%；LSIL 중활검위 CIN 자24례,병리조직학부합솔위70.59%；HSIL 중활검위 CIN 자66례,병리조직학부합솔위89.19%；SCC 중활검위SCC 자2례,병리조직학부합솔위100.00%。TCT 양성자여병리조직학총부합솔체63.56%。1092례수검자중, HPV 양성자512례, 검출솔위46.89%。기중병리활검위염증자332례, 점 64.84%,병리활검위CIN Ⅰ급급이상자180례,점35.16%(기중 CIN Ⅰ급128례、CIN Ⅱ급30례、CIN Ⅲ급20례、SCC 2례)。여 TCT 검사적조직부합솔(63.56%)상비,차이유통계학의의(χ2=52.86, P<0.05)。결론여 HPV 병독검측상비, TCT 검측적조직학진단부합솔경고,특별시대우 TCT 검측결과위 HSIL 자；대우 TCT 검측결과위 ASCUS 자, HPV 병독검측가이기도유효적분류관리작용。
Objective To investigate different clinical application value of thinprep cytology test (TCT) and high risk human papilloma virus (HPV) detection in screening of cervical intraepithelial neoplasia. Methods TCT and high risk HPV detection were given to 1092 women aging 25~57 years old. Colposcopic biopsy and pathological detection were made for patients with atypical squamous cells of undetermined significance (ASCUS) in TCT and positive high risk HPV detection. Results Among 1092 patients in TCT, there were 236 positive TCT cases, with the detection rate as 21.61%. There were 126 ASCUS cases, 34 low-grade squamous intraepithelial lesion (LSIL) cases, 74 high-grade squamous intraepithelial lesion (HSIL) cases, and 2 squamous cell carcinoma cases. Biopsy showed 58 cervical intraepithelial neoplasia (CIN) cases in ASCUS, with histopathologic coincidence rate as 46.03%; 24 CIN cases in LSIL, with histopathologic coincidence rate as 70.59%; 66 CIN cases in HSIL, with histopathologic coincidence rate as 89.19%; 2 CIN cases in SCC, with histopathologic coincidence rate as 100%. Total histopathologic coincidence rate in positive TCT patients was 63.56%. There were 512 positive HPV cases among 1092 patients, with detection rate as 46.89%. Biopsy showed 332 inflammation cases, accounting for 64.84%, 180 CIN Ⅰ and higher level cases, accounting for 35.16% (128 CIN Ⅰ cases, 30 CIN Ⅱ cases, 20 CIN Ⅲ cases, and 2 SCC cases). The difference of coincidence rate in TCT (63.56%) had statistical significance (χ2=52.86, P<0.05). Conclusion Comparing with HPV detection, TCT provides higher histopathologic coincidence rate, especially for those with HSIL in TCT. HPV detection can provide scattered management effect for ASCUS cases in TCT.
