LCT及HR-HPV诊断宫颈上皮内瘤变的临床价值
发布时间：2018-07-28 15:17
【摘要】：目的分析LCT(liquid-based cervical cytology)和HR-HPV(high-risk human papillomavirus)与阴道镜下宫颈活检组织病理学诊断结果,探讨LCT和HR-HPV对宫颈上皮内瘤变的诊断价值。方法对2013年1月~2014年1月在青岛大学附属医院本部院区门诊行LCT检查的20479例患者的临床资料进行回顾性分析,选取行HR-HPV检测及阴道镜下宫颈活检的1534例患者作为研究对象,比较LCT、HR-HPV检测与阴道镜下宫颈活检对宫颈上皮内瘤变的检出率。细胞学诊断应用2001版TBS分级系统,以未明确意义的不典型鳞状细胞(atypical squamous cell of undetermined significance,ASC-US)及其以上病变作为阳性诊断。以组织病理学结果作为诊断的金标准。结果1.20479例LCT检查结果示未见上皮内病变或恶性病变(NILM)19151例占93.52%,ASC-US及以上级别病变1328例,阳性检出率为6.48%(1328/20479)。LCT结果为ASC-US、LSIL、ASC-H、HSIL、宫颈癌中CINI及以上宫颈病变的检出率分别为43.55%(334/767)、51.91%(95/183)、83.19%(99/119)、91.88%(181/197)、100%(5/5),经卡方检验,ASC-US与LSIL、ASC-H与HSIL差别无显著意义(P0.05),ASC-H、HSIL均高于ASC-US及LSIL,差别有显著意义(P0.05)。2.ASC-US、LSIL、ASC-H、HSIL、宫颈癌中HR-HPV的阳性率分别为77.44%、68.31%、84.87%、96.45%、100%。在LCT各阳性结果中HR-HPV的阳性率逐渐增高,差别有显著意义(P0.05)3.HR-HPV阳性组与阴性组比较,高级别宫颈上皮内瘤变的检出率分别为44.33%、10.16%,差别有非常显著意义(P0.01)。4.ASC-US中HPV阳性者宫颈高级别上皮内瘤变及宫颈癌的检出率为26.60%(158/594)明显高于HPV阴性者4.05%(7/173),差别有非常显著意义(P0.01)。HPV阴性者无宫颈癌的检出。5.LSIL中HPV阳性者宫颈高级别上皮内瘤变及宫颈癌的检出率为33.60%(42/125)明显高于HPV阴性者13.79%(8/58),差别有显著意义(P0.05)。6.263例液基细胞学阴性、HR-HPV阳性者行阴道镜下宫颈活检病理结果为宫颈高级别上皮内瘤变及宫颈癌44例,检出率为16.73%(44/263)。结论1.LCT及HR-HPV是检测宫颈病变的有效筛查方法,二者联合检测的诊断准确性更高。2.HR-HPV检测对细胞学诊断为ASC-US的患者有重要的分流价值。3.细胞学阴性、HR-HPV阳性的女性有患宫颈高级别上皮内瘤变及宫颈癌的风险,对此类患者行阴道镜下宫颈活检可以减少漏诊。
[Abstract]:Objective to analyze the pathological diagnosis results of LCT (liquid-based cervical cytology) and HR-HPV (high-risk human papillomavirus) and cervical biopsy under colposcopy) and to explore the value of LCT and HR-HPV in the diagnosis of cervical intraepithelial neoplasia. Methods the clinical data of 20479 patients with LCT from January 2013 to January 2014 were analyzed retrospectively. 1534 patients who underwent HR-HPV examination and cervical biopsy under colposcopy were selected as the study objects. To compare the detection rate of HR-HPV with cervical biopsy under colposcopy for cervical intraepithelial neoplasia. 2001 TBS grading system was used for cytological diagnosis. The atypical squamous cell (atypical squamous cell of undetermined significance ASC-US) and above lesions were used as positive diagnosis. Histopathological results were taken as the golden criteria for diagnosis. Results the results of LCT in 1.20479 cases showed that there were no intraepithelial lesions or malignant lesions in 19151 cases (93.52%). 1328 cases had ASC-US or above grade lesions. 闃虫，
本文编号：2150667
[Abstract]:Objective to analyze the pathological diagnosis results of LCT (liquid-based cervical cytology) and HR-HPV (high-risk human papillomavirus) and cervical biopsy under colposcopy) and to explore the value of LCT and HR-HPV in the diagnosis of cervical intraepithelial neoplasia. Methods the clinical data of 20479 patients with LCT from January 2013 to January 2014 were analyzed retrospectively. 1534 patients who underwent HR-HPV examination and cervical biopsy under colposcopy were selected as the study objects. To compare the detection rate of HR-HPV with cervical biopsy under colposcopy for cervical intraepithelial neoplasia. 2001 TBS grading system was used for cytological diagnosis. The atypical squamous cell (atypical squamous cell of undetermined significance ASC-US) and above lesions were used as positive diagnosis. Histopathological results were taken as the golden criteria for diagnosis. Results the results of LCT in 1.20479 cases showed that there were no intraepithelial lesions or malignant lesions in 19151 cases (93.52%). 1328 cases had ASC-US or above grade lesions. 闃虫，
本文编号：2150667
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