摘要
目的探讨人乳头瘤病毒(HPV)检测、宫颈液基薄层细胞学检查(TCT)联合阴道镜筛查宫颈癌的临床应用价值。方法以2015—2017于该院行宫颈癌筛查的10 000例农村籍妇女为研究对象,依据筛查方法不同分为两组。2016—2017年5 000例作为实验组,患者先行HPV检测,高危HPV16、18阳性者直接阴道镜下活检,其他HPV阳性者行TCT检查,异常者再行阴道镜下活检;2015年5 000例作为对照组,患者先行TCT检查,异常者再行阴道下活检。对比观察两组宫颈癌及癌前病变筛查效果。结果实验组诊断正常/炎症4 926例(98.52%),宫颈上皮内瘤变74例(1 480/10万),宫颈癌0例(0),与对照组诊断正常炎症4 972(99.44%),宫颈上皮内瘤变26例(520/10万),宫颈癌2例(4/10万)比较差异有统计学意义(χ~2=1.71,P>0.05,χ~2=3.48,P<0.05;χ~2=3.26,P<0.05)。结论HPV、TCT联合阴道镜是筛查宫颈癌的有效手段,其中先行HPV检测,高危型阳性直接阴道镜活检可减少诊断步骤,对减少筛查工作量具有积极作用,更具推广价值。
Objective To study the clinical application value of HPV, TCT and vaginoscopy in the screening of cervical carcinoma. Methods 10000 cases of rural women for screening of cervical carcinoma in our hospital from 2015 to 2017 were selected and divided into two groups according to the screening methods, with 5 000 cases in each, the experimental group from 2016 to 2017 used the HPV test firstly, and the high-risk HPV16, 18 positive cases were for biopsy under colposcopy then, and the control group in 2015 used the TCT examination firstly, and the abnormal patients were for transvaginal biopsy then, and the cervical carcinoma and screening effect before cancer were compared and observed. Results There were normal/inflammation 4 926 cases（98.52%）,74 cases with cervical intraepithelial neoplasia（14 800/100 thousand）, 0 case（0） with cervical carcinoma, and in the control group, 26 cases（ 5 200/100 thousand）,2 cases（ 40/100 thousand）, and the differences were statistically significant（χ2=3.483, P0.05;χ~2=3.26, P0.05）. Conclusion The HPV, TCT and vaginoscopy are the effective means of screening of cervical carcinoma, and the HPV test and high-risk positive biopsy via colposcopy can reduce the diagnosis procedure, which is of positive significance to reducing the screening workload, and it is of promotion value.
作者
陈水琴
CHEN Shui-qin(Department of Gynecology and Obstetrics,Qidong Third People＇s Hospital,Qidong,Jiangsu Province,226200 China)
出处
《系统医学》
2018年第16期128-129,132,共3页
Systems Medicine
关键词
宫颈癌
癌前病变
HPV检测
TCT
阴道镜活检
筛查价值
Cervical carcinoma
Precancerous lesion
HPV test
TCT
Biopsy via colposcopy
Screening value
