摘要
目的对宫颈细胞学、高危型HPV和联合检测(细胞学联合高危型HPV检测)3种方法在检出宫颈癌及癌前病变中的作用进行了比较。方法从2014年1月至2015年12月在北京大学第三医院妇科门诊自愿行机会性筛查的妇女,进行宫颈细胞学检查和高危型HPV检测及阴道镜检查和宫颈活检组织病理学检查。宫颈细胞学采用Surepath和Thinprep液基薄片的方法,高危型HPV检测采用HC2和Cobas 4800检测系统。结果两年间共有3 467例妇女入组进行机会性筛查,年龄24~65岁,宫颈细胞学检出宫颈癌及癌前病变的漏诊率(9.03%)高于高危型HPV检测(2.66%)和联合检测(0.21%),差异有统计学意义(P<0.001)。高危型HPV阳性的ASC-US、ASC-H、LSIL、HSIL和AGC经组织病理学检出≥CIN2病变的概率均比HPV阴性者高(P<0.05)。结论联合检测检出宫颈癌及癌前病变的漏诊率低于细胞学和HPV检测,联合检测能为异常筛查结果的管理提供更多指导临床的信息,并有助于提高宫颈腺癌的检出。
Objective To compare the effect of cervical liquid based cytology and high risk human papillomavirus （hr HPV） test and co-testing （cervical cytology ＋ hr HPV test） on screening of cervical intraepithelial neoplasia 2 （CIN2） or greater lesions. Methods The cervical cytology, high risk HPV test, colposcopy and biopsy were performed in outpatient center of gynecologic department from 2014 to 2015. Surepath and Thinprep liquid based cytology was chosen for cytology, HC2 and Cobas 4800 system applied for hr HPV test. Results A total of 3 467 women recruited during this two years. The CIN2 or greater lesion misdiagnosed by cytology （9.03 %） was higher than that ofhr HPV test （2,66 %） and cotesting （0.21%） （P 〈 0.001 ） . The CIN2 or greater lesions detected in abnormal cytology including ASC-US, ASC-H, LSIL, HSIL and AGC with hr HPV positive was more than in those with HPV negative（P 〈 0.05） . Conclusions The CIN2 or greater lesions misdiagnosed by co-testing was lower than that of cytology and hr HPV test. The co-testing could provide more information for management of abnormal results of cervical screening and very helpful in detection of adenocarcinoma.
出处
《中国妇产科临床杂志》
CSCD
北大核心
2017年第1期3-6,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
国家重点基础研究发展计划(2014CBA02003)
国家自然科学基金资助项目(81472429)
