赵润珍山西省汾阳医院病理科，山西汾阳　032200

液基细胞学、HPV-DNA及hTERC基因联合检测在宫颈癌筛查中的应用价值

赵润珍
山西省汾阳医院病理科，山西汾阳032200

目的 探讨TCT、HPV-DNA及hTERC基因联合检测在宫颈癌筛查中的应用价值。 方法 对480例筛查者分别进行TCT、HPV-DNA和hTERC基因检测，并以病理学检测结果为参照标准，对三种检查方法的敏感度、特异度及符合率进行分析。结果480例受检者中，TCT检测异常49例，HPV阳性54例，hTERC基因扩增阳性29例。单一筛查时，TCT灵敏度最高，hTERC特异度和符合率最高；联合筛查时，TCT+HPV（+）灵敏度最高，HPV+ hTERC（+）特异度和符合率最高，单项筛查和联合筛查的检出率均与病理级别有关（P＜0.05）。结论 联合检查应用于宫颈癌筛查中，优势较为明显，其中以HPV-DNA联合hTERC基因检测效果最为理想，检查结果均与宫颈高级别病变存在密切的关系。

宫颈癌；HPV-DNA；hTERC基因；联合检测；早期诊断

［Abstract］Objective To study the application value of combined detection of TCT，HPV-DNA and hTERC genes in screening of cervical cancer.Methods 480 subjects were examined by TCT testing，HPV-DNA and hTERC genes detection.The sensitivity，specificity and coincidence rate of the three methods were studied with the results of pathological examination as the reference standard.Results In 480 subjects，abnormalities were found in 49 cases by using TCT testing，further，54 cases were HPV-positive，and amplification positive PCR product of hTERC gene were detected in 29 cases.Single-arm screening results indicated that TCT had the highest sensitivity，and hTERC had the highest specificity and coincidence rate；by combined screening，the sensitivity of TCT+HPV（+）was the highest，while the HPV+hTERC（+）had the highest specificity and coincidence rate.Both single-arm screening and combined screening were correlated with histological grades，with statistical significance（P＜0.05）.Conclusion Combined examination has a remarkable advantage for the screening of cervical cancer over the single-arm screening，and the detection effect of HPV-DNA combined with hTERC gene is most evident.Besides，the inspection results are closely correlated the high levels of cervical lesions.

［Key words］Cervical cancer；HPV-DNA；hTERC gene；Combined detection；Early diagnosis

宫颈癌（cervical cancer，CC）是临床上常见的妇科恶性肿瘤之一，其发病率仅次于乳腺癌，我国每年大约近3万人死于宫颈癌［1-3］，早期诊断对癌前病变的筛查和治疗及预防有着非常重要的意义，采用有效的检查方法是提高宫颈癌早期诊断正确率的关键，目前筛查宫颈癌已成为研究的热点［4］。随着宫颈细胞学在临床上得以广泛应用，如液基细胞学（TCT）、人乳头瘤病毒（human papilloma virus，HPV）和染色体端粒酶（hTERC）基因检测等［5］，使得癌前病变的及早发现和早期治疗取得了很大的进展，宫颈癌的发病率和死亡率均得到明显下降［6］。hTERC基因检测是TCT和 HPV检测方法的有力补充，三者联合有助于宫颈癌早期诊断和治疗后随访。……