摘要
目的评价不同方案进行宫颈癌筛查的临床应用价值。方法 2008年7月至2010年2月在中日友好医院妇科门诊同时采用宫颈液基细胞学检查(liquid-based cytologic test,LCT)和高危型人乳头瘤病毒(HR-HPV)筛查宫颈癌妇女1052例,对LCT提示≥ASC-US或HR-HPV阳性者或醋酸试验阳性者进行阴道镜下宫颈活组织检查,以病理结果为金标准评价LCT、HPV、LCT+HPV平行试验、LCT-HPV系列试验、HPV-LCT系列试验5种方案筛查宫颈高度病变的价值。结果 LCT、HPV、LCT+HPV平行试验、LCT-HPV系列试验与HPV-LCT系列试验筛查宫颈癌的敏感性分别为73.86%、93.18%、98.86%、90.34%和86.93%;特异性分别为90.87%、77.74%、71.57%、83.79%和86.76%;阳性预测值分别为61.90%、45.68%、41.13%、52.82%和56.88%;阴性预测值分别为94.54%、98.27%、99.68%、97.74%和97.06%;各筛查方案诊断价值相近,差异均无统计学意义(P>0.05);LCT-HPV系列试验的各项价值与LCT+HPV平行试验相近,费用效益比更为理想。结论 LCT-HPV系列试验在获得良好筛查价值的同时显著降低了宫颈癌初筛的费用。
Objective To evaluate the clinical application values of different cervical intraepithlial neoplasia screening programs.Methods We performed liquid-based cytologic test（LCT）and Hybrid Capture II（HC-II） in 1 052 women in China-Japan Friendship Hospital from July 2008 to February 2010.Those with abnormal cytological results,positive HR-HPV DNA or visual inspection with acetic acid received biopsy and endocervical curettage under colposcopy.Final diagnosis would depend on pathological findings.Results The sensitivity of LCT,HR-HPV,LCT＋HPV parallel test（each woman accept both HPV and LCT tests at the same time）,LCT-HPV serial test（HPV is only applied for women with abnormal LCT results） and HPV-LCT serial test（only women with positive HPV accept LCT test） was 73.86%,93.18%,98.86%,90.34% and 86.93%;the specificity was 90.87%,77.74%,71.57%,83.79% and 86.76%;the positive prediction values were 61.90%,45.68%,41.13%,52.82% and 56.88%,and the negative prediction values were 94.54%,98.27%,99.68%,97.74% and 97.06%.There were no significant differences of screening effects between these screening programs（P0.05）;The cost-effecs ratio of LCT-HPV series test was higher than LCT＋HPV parallel test.Conclusions The results suggested the LCT-HPV serial test may get the same values with less cost.
出处
《中国妇产科临床杂志》
2012年第2期115-118,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
人乳头瘤病毒
子宫颈上皮内瘤变
子宫颈癌
筛查
papillomavirus
human
cervical intraepithlial neoplasia
cervical cancer
screening
