医学检验与临床
醫學檢驗與臨床
의학검험여림상
Medical Laboratory Science and Clinics
2015年
4期
38-41,60
,共5页
宫颈疾病%液基薄层细胞学检查%阴道镜检查%人乳头瘤病毒%宫颈环形电切术
宮頸疾病%液基薄層細胞學檢查%陰道鏡檢查%人乳頭瘤病毒%宮頸環形電切術
궁경질병%액기박층세포학검사%음도경검사%인유두류병독%궁경배형전절술
Cervical disease%Thin-prep cytology%Colposcope%Human papil omavirus%Cervical loop electrosurgical excision procedure
目的:分析阴道镜活检、液基薄层细胞学检查( TCT )、人乳头瘤病毒( HPV )检测、宫颈环形电切术( LEEP)四种检查方法在宫颈病变中的临床应用价值。方法:对2012年1月~2014年3月在我院宫颈门诊就诊的1038例患者进行TCT检查和HPV-DNA分型检测,对细胞学诊断≥ASCUS及HPV检测为阳性的病例进行阴道镜活检,部分病例行LEEP手术,切下的标本送病检,分析四种检查方法的结果。结果:①TCT检查1038例中,阳性202例,检出率19.46%,TCT阳性报告者中CIN及宫颈癌检出率为86.14%。LSIL诊断符合率63.37%,HSIL诊断符合率84.62%,TCT漏诊率为11.22%。②HPV-DNA分型检测1038例病例中,阳性362例,检出率34.87%。随着宫颈病变级别上升HPV感染率增加,CINⅠ、CINⅡ、CINⅢ及浸润癌中HPV (+)检出率分别为60.2%、75%、93.1%和100%③TCT(+) HPV (+)组中CIN以上的病变检出率为95.38%;TCT(-)HPV (-)组中CIN以上的病变检出率为63.16%,未发现CINⅢ及以上病。④LEEP刀术后病理与阴道镜活检病理诊断完全符合率为69.68%,其中CINⅠ符合率为83.1%,CINⅡ符合率为63.5%,CINⅢ符合率为58.6%。结论:严格掌握宫颈病变的“三阶梯”诊断技术,合理使用TCT、HPV-DNA检测、阴道镜检查及LEEP刀,可以提高宫颈病变的诊断率。
目的:分析陰道鏡活檢、液基薄層細胞學檢查( TCT )、人乳頭瘤病毒( HPV )檢測、宮頸環形電切術( LEEP)四種檢查方法在宮頸病變中的臨床應用價值。方法:對2012年1月~2014年3月在我院宮頸門診就診的1038例患者進行TCT檢查和HPV-DNA分型檢測,對細胞學診斷≥ASCUS及HPV檢測為暘性的病例進行陰道鏡活檢,部分病例行LEEP手術,切下的標本送病檢,分析四種檢查方法的結果。結果:①TCT檢查1038例中,暘性202例,檢齣率19.46%,TCT暘性報告者中CIN及宮頸癌檢齣率為86.14%。LSIL診斷符閤率63.37%,HSIL診斷符閤率84.62%,TCT漏診率為11.22%。②HPV-DNA分型檢測1038例病例中,暘性362例,檢齣率34.87%。隨著宮頸病變級彆上升HPV感染率增加,CINⅠ、CINⅡ、CINⅢ及浸潤癌中HPV (+)檢齣率分彆為60.2%、75%、93.1%和100%③TCT(+) HPV (+)組中CIN以上的病變檢齣率為95.38%;TCT(-)HPV (-)組中CIN以上的病變檢齣率為63.16%,未髮現CINⅢ及以上病。④LEEP刀術後病理與陰道鏡活檢病理診斷完全符閤率為69.68%,其中CINⅠ符閤率為83.1%,CINⅡ符閤率為63.5%,CINⅢ符閤率為58.6%。結論:嚴格掌握宮頸病變的“三階梯”診斷技術,閤理使用TCT、HPV-DNA檢測、陰道鏡檢查及LEEP刀,可以提高宮頸病變的診斷率。
목적:분석음도경활검、액기박층세포학검사( TCT )、인유두류병독( HPV )검측、궁경배형전절술( LEEP)사충검사방법재궁경병변중적림상응용개치。방법:대2012년1월~2014년3월재아원궁경문진취진적1038례환자진행TCT검사화HPV-DNA분형검측,대세포학진단≥ASCUS급HPV검측위양성적병례진행음도경활검,부분병례행LEEP수술,절하적표본송병검,분석사충검사방법적결과。결과:①TCT검사1038례중,양성202례,검출솔19.46%,TCT양성보고자중CIN급궁경암검출솔위86.14%。LSIL진단부합솔63.37%,HSIL진단부합솔84.62%,TCT루진솔위11.22%。②HPV-DNA분형검측1038례병례중,양성362례,검출솔34.87%。수착궁경병변급별상승HPV감염솔증가,CINⅠ、CINⅡ、CINⅢ급침윤암중HPV (+)검출솔분별위60.2%、75%、93.1%화100%③TCT(+) HPV (+)조중CIN이상적병변검출솔위95.38%;TCT(-)HPV (-)조중CIN이상적병변검출솔위63.16%,미발현CINⅢ급이상병。④LEEP도술후병리여음도경활검병리진단완전부합솔위69.68%,기중CINⅠ부합솔위83.1%,CINⅡ부합솔위63.5%,CINⅢ부합솔위58.6%。결론:엄격장악궁경병변적“삼계제”진단기술,합리사용TCT、HPV-DNA검측、음도경검사급LEEP도,가이제고궁경병변적진단솔。
Objective:To expore the clinical application value of thin-prep cytology test(TCT),biopsy during colposcopy, human papillomavirus test(HPV),loop electrosurgical excision procedure(LEEP) in screening of cervical lesions. Methods:1038 cases from Jan.2012 to Feb.2014 in cervical out-patient department of 181st hospital of Chinese People s Liberation Army were brought into the research. All cases were test by TCT and HPV-DNA typing. One part of 1038 cases which with cytology≥ASCUS and HPV testing postive did colposcopy biopsy.The specimens which cut by LEEP surgery were exam by pathology. The results of four inspection methods were comparatively analyzed.Results:①19.46%of 1038 cases were TCT positive. Which CIN and cervical carcinoma took up 86.14%.LSIL was 63.37%, HSIL was 86.7%. Misdiagnosis rate of TCT was 11.22%.②The positive of HPV-DNA typing was 34.87% (362/1038). The positive rate of HPV presented an ascending trend while the pathological grade going up: CIN Ⅰ was 60.2%, CIN Ⅱ was 75%,CIN Ⅲ was 93.1%,invasive carcinoma was 100%. ③ The detection rate of CIN and above:95.38% in TCT and HPV-positive patients, 63.16% in negative patients, no one was above CINⅢ.④The total coincident rate of the pathological diagnosis of LEEP and biopsy by colposcopy was 69.68%,while CIN I was 83.1%,CIN II was 63.5%, CINⅢwas 58.6%. Conclusions:It should be strictly controlled the"three step"diagnosis technology in cervical lesions, and be reasonable combination of the above four testing methods can enhance diagnosis of cervical leisions.