赵俏猷 郑艺娟 黎金凤

【摘要】 目的：探討子宫颈癌筛查中人类乳头状病毒（human papillomavirus，HPV）检查及薄层液基细胞学（thin-cytologic test，TCT）检查的应用及其临床意义。方法：选取2019年1-12月在本院行子宫颈癌筛查的人群2 026例，将HPV检查和/或TCT检查结果呈阳性者进一步行阴道镜下子宫颈活检，将阴道镜下子宫颈活检的病理诊断作为对比金标准。观察阴道镜的活检情况，TCT检查的异常情况及其跟阴道镜活检结果相比的检查情况。HPV检查的异常情况及其跟阴道镜活检结果相比的检查情况，与病理检查结果相比HPV检查跟TCT检查的符合率。结果：2 026例筛查患者当中对TCT检查和/或HPV检查结果呈阳性的412例患者实施进一步的阴道镜活检，并常规进行病理检查，将病理检查作为对比金标准。412例患者的最终病理诊断结果为：正常（包括鳞状上皮化生及慢性宫颈炎）74例，CINⅠ 122例，CINⅡ 96例，CINⅢ 100例，子宫颈浸润癌20例。所有2 026例筛查患者中共检查出TCT异常涂片376例（18.6%），其中ASCUS 226例（11.2%），LSIL 76例（3.8%），HSIL 68例（3.3%），SCC 6例（0.3%）。所有2 026例筛查患者中HPV感染者410例（20.2%），其中CINⅠ 90例（22.0%），CINⅡ 84例（20.5%），CINⅢ 90例（22.0%），宫颈浸润癌18例（4.3%），正常者128例（31.2%）。HPV检查的检出比率显著比TCT检查高，比较差异均有统计学意义（P<0.05）。结论：临床中进行子宫颈癌筛查的过程中应用HPV检查，相比TCT检查，可显著提高对宫颈癌及癌前病变的临床诊断准确性。

【关键词】 子宫颈癌 病理组织细胞学 TCT检查

Application of Human Papillomavirus and Thin-cytologic Test in Cervical Cancer Screening and Its Clinical Significance/ZHAO Qiaoyou， ZHENG Yijuan， LI Jinfeng. //Medical Innovation of China， 2021， 18（01）： -155

[Abstract] Objective： To investigate the application of human papillomavirus （HPV） and thin-cytologic test （TCT） in cervical cancer screening and its clinical significance. Method： A total of 2 026 patients who were screened for cervical cancer in our hospital from January to December 2019 were selected. Those who tested positive for HPV and / or TCT were further colposcopically treated with cervical biopsy. The pathological diagnosis of cervical biopsy was used as the comparative gold standard. The colposcopy biopsy， the abnormalities of TCT examination and its comparison with the results of colposcopy biopsy， abnormalities of HPV examination and its comparison with colposcopy biopsy results were observed. The results of pathological examination， the coincidence rate of HPV examination and TCT examination were compared. Result： Among 2 026 screening patients， 412 patients who tested positive for TCT and / or HPV were given further colposcopy biopsy， and routine pathological examination was performed， pathological examination was used as the comparison gold standard. The final pathological diagnosis of 412 patients： normal （including squamous metaplasia and chronic cervicitis） of 74 cases， CINⅠ of 122 cases， CINⅡ of 96 cases， CINⅢ of 100 cases， cervical invasive carcinoma of 20 cases. Among all 2 026 screening patients， a total of TCT abnormal smears were detected 376 cases （18.6%）， Among them， ASCUS of 226 cases （11.2%）， LSIL of 76 cases （3.8%）， HSIL of 68 cases （3.3%）， and SCC of 6 cases （0.3%）. Among 2026 patients， HPV testing revealed 410 cases （20.2%） HPV infections. Among 410 cases of HPV infection， CINⅠ of 90 cases （22.0%）， CINⅡ of 84 cases （20.5%）， CINⅢ of 90 cases （22.0%）， Invasive cervical cancer of 18 cases （4.3%）， and normal cases of 128 cases （31.2%）. The detection rate of HPV was significantly higher than that of TCT （P<0.05）. Conclusion： The use of HPV during cervical cancer screening in clinical practice can significantly improve the accuracy of clinical diagnosis of cervical cancer and precancerous lesions compared with TCT.

[Key words] Cervical cancer Histopathology TCT detection

First-authors address： Maternal and Child Health Hospital of Dianbai District in Maoming City， Maoming 525400， China

doi：10.3969/j.issn.1674-4985.2021.01.037

随着社会的不断发展，女性群体患有子宫颈癌的相关因素越来越多，且来自各个不同方面，使得临床中子宫颈癌的发病比率显著升高，而最常见的一种诱发子宫颈癌因素就是感染高危型人乳头状瘤病毒（papillomavirus，HPV）[1]。医学临床中将高危型HPV分为两种不同的类型，临床中检测高危型HPV型能够更进一步地对疾病演变情况进行明确诊断，同时还可以更好的评估患者预后[2]。……