液基薄层细胞检查与高危型人乳头瘤病毒检测在宫颈癌筛查中的应用价值

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　　[摘要]目的 分析液基薄层细胞（TCT）检查与高危型人乳头瘤病毒（HPV）检测在宫颈癌筛查中的应用价值。方法 选取2018年1月～2019年3月于我院行宫颈癌疾病筛查的260例患者作为研究对象，所有患者均接受TCT、HPV检查与病理活检。以病理活检结果作为疾病诊断金标准，评估TCT及HPV行单一或联合疾病检查的灵敏度、特异度与诊断符合率。结果 病理活检诊断炎症133例，宫颈上皮内瘤样变（CIN）119例，宫颈癌8例。高危型HPV检查的诊断符合率为79.23%，灵敏度为75.59%，特异度为82.71%;TCT检查的诊断符合率为83.46%，灵敏度为80.31%，特异度为86.47%;联合检查的诊断符合率为96.92%，灵敏度为96.85%，特异度为96.99%。联合检查的诊断符合率、灵敏度及特异度均高于HPV、TCT单一检测，差异有统计学意义（P<0.05）。结论 推荐疑似宫颈癌患者行高危型HPV及TCT联合检查，临床诊断符合率高，灵敏度、特异度佳，可为临床疾病的诊断提供较精准的参考依据，值得推广。
　　[关键词]高危型;液基薄层细胞检查;高危型人乳头瘤病毒检测;宫颈癌;筛查
　　[Abstract] Objective To analyze the application value of thin-cytologic test （TCT） and high-risk human papilloma virus （HPV） examination for screening of cervical cancer. Methods A total of 260 cases of cervical cancer screening in our hospital from January 2018 to March 2019 were selected as the study subjects. All patients received TCT， HPV examination and pathological biopsy. The sensitivity， specificity and coincidence rate of TCT and HPV in single or combined disease examination were evaluated by pathological biopsy results as the gold standard of disease diagnosis. Results Pathological examination indicated 133 cases inflammation， 119 cases cervical intraepithelial neoplasia （CIN） and 8 cases cervical cancer. The diagnosis accordance rate， sensitivity and specificity based on HPV was 78.46%， 73.08% and 86.54%; the diagnosis accordance rate， sensitivity and specificity based on TCT was 85.38%， 83.09% and 87.90%; the diagnosis accordance rate， sensitivity and specificity based on combined examination was 96.92%， 96.85% and 96.99%. The diagnosis accordance rate， sensitivity and specificity of combined examination were higher than those of HPV or TCT， with statistically significant differences （P<0.05）. Conclusion For suspected cervical cancer patients， the combined examination of HPV and TCT has higher diagnosis accordance rate， sensitivity and specificity， providing references on clinical diagnosis. It is worthy of promotion.
　　[Key words] High-risk; Thin-cytologic test; High-risk human papilloma virus detection; Cervical cancer; Screening
　　宮颈癌作为一类妇科恶性肿瘤疾病，致病诱因与高危型人乳头瘤病毒（HPV）持续感染相关[1]。性生活不洁、多孕多产、营养不良、不注意个人卫生等均可致宫颈癌变发生[2]。原位癌高发年龄段在30～35岁，浸润癌稍迟，在45～55岁。但随着人们近年来生活节奏的变化，加之来自外界的压力激增，致使临床宫颈癌发病呈现年轻化趋势[3]。而疾病早期体征、症状皆不显著，随着疾病恶性进展，发展至中晚期，可表现为阴道异常流血、排液、便秘、尿急、尿频、下肢肿痛等症状。癌变位肿大下对输尿管造成压迫，引发输尿管梗阻，危重预后下并发尿毒症[4]。因此，展开积极的疾病筛查，促疾病早发现、早治疗，临床意义重大。目前，临床常见的宫颈癌诊断方法包含有高危型HPV检测及液基薄层细胞（TCT）检查[5]。本研究选取于我院行宫颈癌疾病筛查的260例患者作为研究对象，旨在探讨TCT检查与高危型HPV检测在宫颈癌筛查中的应用价值，现报道如下。
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