摘要/Abstract

摘要： 目的 ·探讨宫颈细胞学和高危型人乳头瘤病毒（ human papillomavirus，HPV）联合检测在宫颈腺癌中的诊断价值。方法 ·回顾性分析 2006年 1月—2017年 12月上海交通大学医学院附属国际和平妇幼保健院收治的所有病理组织学确诊为宫颈腺癌患者的临床资料，通过比较分析单纯细胞学检查、单纯高危型 HPV检测以及细胞学联合高危型 HPV检测的诊断价值。结果 · 2 291例宫颈癌患者中 480例为宫颈腺癌患者，最终纳入 409例患者进行分析。患者平均年龄为（ 46.8±11.4）岁，其中 35～ 55岁年龄段患者占比为 59.2%。按检测方法将患者分为 A组（单纯细胞学检测， n208）、B组（单纯高危型 HPV检测， n103）和 C组（细胞学和高危型 HPV联合检测， n98）。A组细胞学检测阳性例数为 142例，阳性检出率为 68.3%；B组高危型 HPV检测阳性例数为 85例，阳性检出率为 82.5%；C组联合检测阳性例数为 93例，阳性检出率为 94.9%。3组之间差异有统计学意义（ P0.000）。在宫颈原位腺癌患者中， A组阳性检出率为 70.6%，而 B组和 C组患者均为 100.0%，B组和 C组显著优于 A组（P0.000）。在宫颈浸润性腺癌患者中， A组阳性检出率为 67.9%，B组为 75.8%，C组为 91.8%，3组之间差异有统计学意义（ P0.000）。结论 ·宫颈细胞学联合高危型 HPV检测可以显著提高宫颈腺癌的阳性检出率。
关键词: 宫颈腺癌, 宫颈细胞学检查, 高危型人乳头瘤病毒检测, 联合诊断
Abstract:
Objective · To investigate the diagnostic value of combined detection of cervical cytology and high-risk human papillomavirus (HPV) in cervical adenocarcinoma. Methods · The clinical data of patients diagnosed as cervical adenocarcinoma in the International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine January 2006 to December 2017 were retrospectively collected and analyzed. A comparison among cytology detection, high-risk HPV test, and combined detection of both methods was performed. Results · A total of 2 291 cases of cervical cancer were collected, of which 480 cases were cervical adenocarcinoma patients. Finally, 409 cases of cervical adenocarcinoma were analyzed. The average age of all included patients was (46.8±11.4) years old. The proportion of the patients aged 35-55 was 59.2%. All the patients were divided into three groups, i.e., group A (cytology detection, n208), group B (high-risk HPV test, n103), and group C (cytology and high-risk HPV combined test, n98). There were 142 (68.3%), 85 (82.5%), and 93 (94.9%) positive cases in group A, B, and C, respectively. There was a statistically significant difference among the three groups (P0.000). In the patients with cervical in situ adenocarcinoma, the positive detection rates in group A, B and C were 70.6%, 100.0% and 100.0%, respectively (P0.000). And in the patients with cervical invasive adenocarcinoma, the positive detection rates in group A, B, and C were 67.9%, 75.8% and 91.8%, respectively (P0.000). Conclusion · Cervical cytology combined with high-risk HPV detection can significantly increase the positive detection rate of cervical adenocarcinoma.
Key words: cervical adenocarcinoma, cervical cytology detection, high-risk human papillomavirus test, combined diagnosis


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