摘要
目的探讨宫颈液基细胞学检查(TCT)联合高危型人乳头瘤病毒(HR-HPV)核酸检测在宫颈癌筛查中的应用价值。方法回顾性分析332例经TCT诊断为意义不明确的非典型鳞状细胞(ASC-US)患者的HR-HPV核酸检测结果和组织病理检查结果,将ASC-US患者按不同年龄段分为青年组及中老年组,比较2组HR-HPV结果及宫颈组织病理检查结果。结果 TCT(ASC-US)且HR-HPV(+)组的宫颈组织病理学符合率高于TCT(ASC-US)且HR-HPV(-)组、TCT(阴性)且HR-HPV(+)组,差异有统计学意义(P <0.001);青年组的HR-HPV核酸阳性率、组织病理学阳性率与中老年组比较,差异有统计学意义(P <0.05);2组ASC-US患者HR-HPV核酸检测的准确率、灵敏度及阳性预测值比较,差异无统计学意义(P> 0.05),但HR-HPV核酸检测的特异度、约登指数、阴性预测值比较,差异有统计学意义(P <0.05);全组、青年组、中老年组患者中,不同级别宫颈病变的HR-HPV阳性率比较,差异均有统计学意义(P <0.05)。结论 TCT诊断为ASC-US的患者联合采用HR-HPV检测可以提高宫颈鳞状上皮内病变的检出率,尤其适用于中老年人群。
Objective To analyze the application value of nucleic acid detection of thinprep cytologic test(TCT)combined with nucleic acid detection of high-risk human papillomavirus(HR-HPV)in screening of cervical cancer.Methods The results of nucleic acid of HR-HPV and histopathology test in 332 cases confirmed as atypical squamous cells of undetermined significance(ASC-US)by TCT were retrospectively analyzed.These confirmed patients were divided into young group and middle and higher aged group according to age.The results of HR-HPV and cervical histopathology were compared between the two groups.Results The patients confirmed as ASC-US by TCT combined with positive HR-HPV had significantly higher histopathological coincidence rate of than those confirmed as ASC-US by TC combined with negative HR-HPV and those without ASC-US combined with positive HR-HPV(P<0.001).The positive rates of HR-HPV nucleic acid and histopathology tests in the young group showed significant differences compared to those of the middle and higher aged group(P<0.05).There were no significant differences in the accuracy,sensitivity and positive predictive value of nucleic acid test of HR-HPV in ASC-US patients of two groups(P>0.05),but there were significant between-group differences in the specificity,Jordan index and negative predictive value of HR-HPV nucleic acid test(P<0.05).There was significant difference in the HR-HPV positive rate of different levels of cervical lesions in the whole group,the young group or the middle and higher-aged group(P<0.05).Conclusion The combination of HR-HPV improves the detection rate of cervical squamous intraepithelial lesions in ASC-US patients confirmed by TCT,and it is especially suitable to middle and higher aged group.
作者
周扬帆
杨晓扬
朱成全
王爱武
陈艳宇
谭夕
陈钰
迮浩城
刘艳红
ZHOU Yangfan;YANG Xiaoyang;ZHU Chengquan;WANG Aiwu;CHEN Yanyu;TAN Xi;CHEN Yu;ZE Haocheng;LIU Yanhong(Department of Pathology,Second People’s Hospital of Guangdong Province,Emergency Hospital of Guangdong Province,Guangzhou,Guangdong,017317;th Army Hospital of Land Force of People’s Liberation Army,Guangzhou,Guangdong,017317;Department of Gynaecology,Second People’s Hospital of Guangdong Province,Emergency Hospital of Guangdong Province,Guangzhou,Guangdong,010317)
出处
《实用临床医药杂志》
CAS
2020年第15期46-50,54,共6页
Journal of Clinical Medicine in Practice
基金
广东省医学科学技术研究基金项目(B2017096)。
