Wang Jin-Liang, Yang Yi-Zhuo, Dong Wei-Wei, Sun Jing, Tao Hai-Tao, Li Rui-Xin, Hu Yi
Department of General Oncology, Chinese PLA General Hospital, Beijing, China.
Asian Pac J Cancer Prev. 2013;14(5):2979-82. doi: 10.7314/apjcp.2013.14.5.2979.
Cervical cancer is a commonly-encountered malignant tumor in women. Cervical screening is particularly important due to early symptoms being deficient in specificity. The main purpose of the study is to assess the application value of cervical thinprep cytologic test (TCT) and human papillomavirus (HPV) detection in screening for cervical cancer and precancerous lesions. In the study, cervical TCT and HPV detection were simultaneously performed on 12,500 patients selected in a gynecological clinic. Three hundred patients with positive results demonstrated by cervical TCT and/or HPV detection underwent cervical tissue biopsy under colposcopy, and pathological results were considered as the gold standard. The results revealed that 200 out of 12,500 patients were abnormal by TCT, in which 30 cases pertained to equivocal atypical squamous cells (ASCUS), 80 cases to low squamous intraepithelial lesion (LSIL), 70 cases to high squamous intraepithelial lesion (HSIL) and 20 cases to squamous cell carcinoma (SCC). With increasing pathological grade of cervical biopsy, however, TCT positive rates did not rise. Two hundred and eighty out of 12,500 patients were detected as positive for HPV infection, in which 50 cases were chronic cervicitis and squamous metaplasia, 70 cases cervical intraepithelial neoplasia (CIN) I, 60 cases CIN II, 70 cases CIN III and 30 cases invasive cervical carcinoma. Two hundred and thirty patients with high-risk HPV infection were detected. With increase in pathological grade, the positive rate of high-risk HPV also rose. The detection rates of HPV detection to CIN III and invasive cervical carcinoma as well as the total detection rate of lesions were significantly higher than that of TCT. Hence, HPV detection is a better method for screening of cervical cancer at present.
宫颈癌是女性常见的恶性肿瘤。由于早期症状缺乏特异性,宫颈筛查尤为重要。本研究的主要目的是评估宫颈液基薄层细胞学检测(TCT)和人乳头瘤病毒(HPV)检测在宫颈癌及癌前病变筛查中的应用价值。本研究对某妇科门诊选取的12500例患者同时进行宫颈TCT和HPV检测。300例宫颈TCT和/或HPV检测结果阳性的患者接受阴道镜下宫颈组织活检,病理结果作为金标准。结果显示,12500例患者中TCT异常者200例,其中意义不明确的非典型鳞状细胞(ASCUS)30例,低级别鳞状上皮内病变(LSIL)80例,高级别鳞状上皮内病变(HSIL)70例,鳞状细胞癌(SCC)20例。然而,随着宫颈活检病理分级的增加,TCT阳性率并未升高。12500例患者中检测出HPV感染阳性者280例,其中慢性宫颈炎伴鳞状化生50例,宫颈上皮内瘤变(CIN)I级70例,CIN II级60例,CIN III级70例,浸润性宫颈癌30例。检测出高危型HPV感染患者230例。随着病理分级增加,高危型HPV阳性率也升高。HPV检测对CIN III级和浸润性宫颈癌的检出率以及病变总检出率均显著高于TCT。因此,目前HPV检测是宫颈癌筛查的较好方法。