阴道镜下活体组织检查联合人乳头瘤病毒检测预测宫颈癌及癌前病变的临床价值(1)
摘 要 目的：评价阴道镜下活体组织检查联合人乳头瘤病毒(HPV)检测预测宫颈癌及癌前病变的临床价值。方法：选择2013年8月-2014年11月在我院宫颈门诊行宫颈液基薄层细胞学(TCT)检测结果异常(非典型鳞状上皮细胞及以上)者289例，随机分为HPV组(行HPV检测，n=103)、阴道镜组(行阴道镜检查，n=94)、联合组(行HPV检测和阴道镜检查，n=92)。所有患者均行宫颈病理检测，比较3种检测方法在预测宫颈癌及癌前病变的价值。结果：3种方法检测阳性率分别为57.28%、59.57%和72.83%(F=4.824， P<0.05)，而病理组织学检测结果阳性率分别为55.93%、55.36%和77.61%(F=5.147， P<0.05)。结论：阴道镜下活体组织检查联合人乳头瘤病毒检测可显著提高宫颈癌及癌前病变的检出率和预测效能，具有较高的临床应用价值。
关键词 宫颈病变 阴道镜下活体组织检查 人乳头瘤病毒检测 预测
中图分类号：R730.4； R737.33 文献标识码：A 文章编号：1006-1533(2015)19-0045-03
Clinical value of the examination of biopsy under colposcopy combined with the detection of human papillomavirus for the prediction of cervical cancer and precancerous lesions
CHEN Lihua1， DENG Xihong2
(1.The first people’s hospital of Ji-an City， Ji-an 343000， China)
2. family planning office of Jinchuan town， Xingan County， Jiangxi Province. Xingan 331300， China)
ABSTRACT Objective： To discuss the clinical value of the examination of biopsy under colposcopy combined with the detection of human papilloma virus (HPV) for the prediction of cervical cancer and precancerous lesions. Methods： Two hundred and eighty-nine cases of patients with atypical squamous cells performing a detection of thinprep cervical cytology (TCT) from August， 2013 to November， 2014 at the department of gynecology in our hospital were selected and randomly divided into a HPV group (underwent HPV test， n=103)， a colposcopy group (underwent colposcopy， n=94)， a combinational group (underwent both， n=92). All patients underwent the detection of cervical pathology and the diagnostic value of three methods were compared. Results： The positive rates in three groups were 57.28%， 59.57% and 72.83%， respectively (F=4.824， P<0.05)， while the positive rates of the detection of cervical pathology were 55.93%， 55.36% and 77.61%， respectively (F=5.147， P <0.05). Conclusion： Colposcopy combined with HPV detection can significantly improve the diagnostic efficacy of cervical cancer and precancerous lesions with a higher value of clinical application.
KEY WORDS cervical lesions； colposcopic biopsy； human papillomavirus detection； prediction
宫颈癌是我国妇科临床诊治中常见的生殖道恶性肿瘤之一，发病率高，且呈现年轻化趋势，严重影响女性人群的身心健康。由于宫颈癌具有较长的癌前病变阶段，故早期筛查并及时给予干预有助于降低其发病率或延缓其病情发展[1]。研究证实[2]，宫颈癌的发病与人乳头瘤病毒(HPV)感染密切相关，而HPV亦一直是宫颈癌早期筛查的重要手段。阴道镜检查是临床常用于宫颈癌筛查的另一主要手段，可直接观察宫颈病变情况，对判断宫颈病变的性质、范围、类型等具有重要意义[3]。为提高宫颈癌及癌前病变筛查的检出率，本研究采用HPV检测联合阴道镜检查，探讨筛查宫颈癌及癌前病变的检出率与病理组织学检查结果的符合情况，并与单独行HPV检测和阴道镜检查进行比较。
1 资料与方法, http://www.100md.com
关键词 宫颈病变 阴道镜下活体组织检查 人乳头瘤病毒检测 预测
中图分类号：R730.4； R737.33 文献标识码：A 文章编号：1006-1533(2015)19-0045-03
Clinical value of the examination of biopsy under colposcopy combined with the detection of human papillomavirus for the prediction of cervical cancer and precancerous lesions
CHEN Lihua1， DENG Xihong2
(1.The first people’s hospital of Ji-an City， Ji-an 343000， China)
2. family planning office of Jinchuan town， Xingan County， Jiangxi Province. Xingan 331300， China)
ABSTRACT Objective： To discuss the clinical value of the examination of biopsy under colposcopy combined with the detection of human papilloma virus (HPV) for the prediction of cervical cancer and precancerous lesions. Methods： Two hundred and eighty-nine cases of patients with atypical squamous cells performing a detection of thinprep cervical cytology (TCT) from August， 2013 to November， 2014 at the department of gynecology in our hospital were selected and randomly divided into a HPV group (underwent HPV test， n=103)， a colposcopy group (underwent colposcopy， n=94)， a combinational group (underwent both， n=92). All patients underwent the detection of cervical pathology and the diagnostic value of three methods were compared. Results： The positive rates in three groups were 57.28%， 59.57% and 72.83%， respectively (F=4.824， P<0.05)， while the positive rates of the detection of cervical pathology were 55.93%， 55.36% and 77.61%， respectively (F=5.147， P <0.05). Conclusion： Colposcopy combined with HPV detection can significantly improve the diagnostic efficacy of cervical cancer and precancerous lesions with a higher value of clinical application.
KEY WORDS cervical lesions； colposcopic biopsy； human papillomavirus detection； prediction
宫颈癌是我国妇科临床诊治中常见的生殖道恶性肿瘤之一，发病率高，且呈现年轻化趋势，严重影响女性人群的身心健康。由于宫颈癌具有较长的癌前病变阶段，故早期筛查并及时给予干预有助于降低其发病率或延缓其病情发展[1]。研究证实[2]，宫颈癌的发病与人乳头瘤病毒(HPV)感染密切相关，而HPV亦一直是宫颈癌早期筛查的重要手段。阴道镜检查是临床常用于宫颈癌筛查的另一主要手段，可直接观察宫颈病变情况，对判断宫颈病变的性质、范围、类型等具有重要意义[3]。为提高宫颈癌及癌前病变筛查的检出率，本研究采用HPV检测联合阴道镜检查，探讨筛查宫颈癌及癌前病变的检出率与病理组织学检查结果的符合情况，并与单独行HPV检测和阴道镜检查进行比较。
1 资料与方法, http://www.100md.com