摘要
目的评价单独或联合应用人乳头状瘤病毒(HPV)21亚型基因检测技术和液基薄层细胞学检测(TCT)筛查女性宫颈癌的临床价值。方法采用偶遇抽样法抽取门诊自愿接受宫颈癌筛查及检查的825名患者,其中383例行TCT检测,370例行HPV21检测,72例行TCT联合HPV21检测。结果 3种筛查方法的灵敏度、特异度、正确指数、阳性似然比、阴性似然比、准确度、Kappa值、ROC曲线下面积分别为:TCT检测(80.00%、83.30%、0.63、4.81、0.24、83.03%、0.411、0.817),HPV21检测(90.06%、50.23%、0.41%、1.82、0.19、66.49%、0.370、0.704),TCT并联HPV21(95.05%、62.45%、0.57、2.53、0.08、71.97%、0.459、0.790),3种方法的特异度、准确度差异均有统计学意义(均P<0.05),3种方法间的ROC曲线下面积进行两两比较显示:TCT、TCT并联HPV21的曲线下面积与HPV21相比差异有统计学意义(均P<0.05)。结论单独应用TCT及TCT并联HPV21检测对于≥CIN-Ⅱ的诊断价值优于HPV21,有较高的灵敏度和特异度,有利于提高宫颈癌诊断的准确性。
Objective To evaluate single or combined application of liquid-based thin-layer cytological test（TCT） and human papilloma viru（HPV） 21 subtype gene detection in cervical cancer screening.Methods A total of 825 voluntary patients were selected using encounter sampling method.TCT was performed in 383 patients,HPV21 detection in 370 patients,and TCT combined with HPV21 detection in 72 patients.Results The sensitivity,specificity,correct index,positive likelihood ratio,negative likelihood ratio,accuracy,Kappa value,and area under the ROC curve were 80.00%,83.30%,0.63,4.81,0.24,83.03%,0.411 and 0.817 for TCT,90.06%,50.23%,0.41%,1.82,0.19,66.49%,0.370 and 0.704 for HPV21 detection,and 95.05%,62.45%,0.57,2.53,0.08,71.97%,0.459 and 0.790 for combination of TCT and HPV21 detection,respectively.There were significant differences in specificity and accuracy among the three methods（all P0.05）.Compared with HPV21 detection,the area under the ROC curve significantly increased for TCT alone or in combination with HPV21 detection（all P0.05）.Conclusion TCT alone and in combination with HPV21 detection have high sensitivity,specificity and accuracare in cervical cancer screening,and are superior to HPV21 alone for≥CIN-Ⅱdiagnostic value.
出处
《实用临床医学（江西）》
CAS
2011年第6期1-4,共4页
Practical Clinical Medicine
基金
江西省卫生厅普通计划(20093035)
