文档介绍：TCT、HPV基因分型检测在山区宫颈疾病筛查中的价值
作者:胡红波,李文静,许红雁
【摘要】目的探讨液基薄层细胞学(TCT)、人乳头状瘤病毒(HPV)基因分型检测这两种方法在宫颈疾病筛查中的应用价值,为制定韶关地区宫颈癌及癌前病变的最佳筛查方案提供科学依据。方法对5002例门诊机会性筛查的宫颈疾病患者按自愿原则采用TCT、HPV基因分型检测,再以宫颈活体组织病理学为标准来验证TCT异常和HPV阳性的筛查结果。结果罹患宫颈癌及癌前病变的女性以青中年为主。TCT检查、HPV检测与病理的符合率是随着病理级别的上升而上升的。%,%。CINⅢ及宫颈癌与高危型HPV感染密切相关,其中以HPV16、18、58为主。两者联合筛查与病理的符合率达100%。结论联合筛查的特异性高于任一种检测手段。能否单用TCT作为宫颈癌的初筛手段,尚值得商榷。持续性高危型HPV感染可进一步发展为宫颈癌。
【关键词】宫颈癌;TCT;HPV;筛查;山区
[Abstract] Objective We approached the screening value of TCT,HPV in the cervical disease,so as to provide a scientific basis for developing cervical cancer and precancerous lesions of the best screening program on Shaoguan Out of 5002 cases of opportunistic screening for cervical disease were used by TCT,HPV genotyping test on a voluntary then we validated the TCT abnormalities and HPV-positive screening results as the standard to cervical tissues and The patients of cervical cancer
and precancerous lesions were made of young coincidence rate between the pathology and HPV,TCT was increased by the rise of pathological single TCT’s false-positive rate was %,while its false-negative rate was % CINⅢ and cervical cancer was closely related to high-risk HPV infection,mainly about HPV16,18, coincidence rate of pathological and TCT,HPV screening together was as high as 100%.Conclusion The specificity of screening together is higher than TCT or HPV TCT could be a initial cervical cancer screening method was still out of high-risk HPV infection made clinical sense of cervical cancer.
[Key words] uterine cervix cancer; TCT;HPV; test facility; mountain area
宫颈癌(cervical carcinoma)是女性生殖系统中最常见而又最具危害性的恶性肿瘤之一。我国宫颈癌形势严峻,%[1],且存在地区差异。韶关地处粤北山区,宫颈癌前病变的诊治手段明显落后于国内大部分发达地区,不少县市一级医院还处于完全依赖巴氏涂片的阶段。本课题旨在引进TCT、HPV等检测方法后,评价其在本地区宫颈疾病筛查中的临床价值。
1 资料与方法
研究对象对2008年4月-2009年8月5002例门诊机会性筛查的宫颈疾病患者按自愿原则采用TCT和HPV基因分型检测。所有患者均有