摘要
目的探讨人乳头瘤病毒(HPV)及液基薄层宫颈细胞学检查(TCT)在宫颈癌早期诊断中的价值。方法回顾性分析笔者医院同时行TCT和HPV-DNA检测且二者任一检测异常并行阴道镜下病理活检的215例女性患者,以组织病理学结果为金标准。结果215例患者中,病理活检显示炎症或正常95例,CINⅠ65例,CINⅡ/Ⅲ50例,宫颈鳞状细胞癌5例。HPV-DNA阳性率随着细胞学异常程度增加而升高,HPV-DNA阳性对于宫颈细胞CINⅡ及以上病变的检出率为31.41%,显著高于HPV-DNA阴性病例检出率10.17%,差异有统计学意义(P<0.05)。而TCT≥HSIL组与TCT<HSIL组对于CINⅡ及以上宫颈细胞病变的检出率分别为76.32%、19.85%,二者比较差异有统计学意义(P<0.05)。HPV-DNA检测阳性对于预测CINⅡ及以细胞瘤变结果的敏感度、特异性、阴性预测值及阳性预测值分别为89.09%、33.13%、89.83%和31.41%;TCT检测≥HSIL对于预测CINⅡ及以上细胞瘤变结果的敏感度、特异性、阴性预测值及阳性预测值分别为52.73%、94.38%、85.31%和76.32%;二者联合检测应用预测宫颈高级别细胞病变的敏感度、特异性、阴性预测值及阳性预测值分别为92.73%、32.50%、92.86%和4679%。结论单一HPV-DNA或TCT检测对于宫颈癌早期筛查具有一定意义,二者联合检测可有效提高高级别宫颈细胞瘤变预测的敏感度,提高宫颈癌及癌前病变的检出率,减少高级别宫颈细胞瘤变的漏诊,对宫颈细胞病变的早期诊断重要价值。
Objective To investigate the value of detection of human papillomavirus(HPV)and ThinPrep cytology test(TCT)in the diagnosis of cervical cancer.MethodsRetrospectively analysis of 215 patients diagnosed as positive result by ThinPrep cytology test and/or HPV DNA test positive was performed.All 215 women with cervical cancer screening underwent HPV-DNA,TCT and colposcopy pathology examination at the same time.ResultsOf the 215 patients,95 cases were pathologically inflammation or normal,65cases were CINⅠ,50 cases were CINⅡ/Ⅲ,and 5 cases were cervical squamous cell carcinoma.The positive rate of HPV-DNA increased with the developing grade of abnormal TCT and increasing level of cervical epithelial neoplasia(CIN).The detection rate of HPV DNA positive for cervical lesions CINⅡand above was 31.41%(49/156),which was significantly higher than HPV DNA negative cases 10.17%(6/59),and the results were significantly different(P<0.05).The detection rates of TCI≥HSIL group and TCT<HSIL group for cervical lesions of CINⅡand above were 76.32%(29/38)and 19.85%(26/131),respectively,which were statistically significant(P<0.05).The sensitivity,specificity,negative predictive value and positive predictive value of HPV DNA test for predicting CINⅡand above pathological results were 89.09%,33.13%,89.83%,and 31.41%,respectively.TCT≥HSIL for predicting pathological results of CINⅡand above sensitivity,specificity,negative predictive value and positive predictive value were 52.73%,94.38%,85.31%,and 7632%,respectively.The combined detection of the two methods was used to predict the sensitivity,specificity,negative predictive value and positive of high-grade cervical cancer.The predicted values are 92.73%,32.50%,92.86%,and 46.79%,respectively.ConclusionThe detection of single HPV DNA or TCT has certain significance for cervical cancer screening.The combined detection can effectively improve the sensitivity of prediction of high-grade cervical cell neoplasia,can increase the detection rate of cervical cancer and precancerous lesions and reduce the missed diagnosis of high-grade lesions in cervical tissue,and have important significance for the early diagnosis and prevention of cervical cancer.
作者
杨飞翔
江俊青
罗克锴
赵铮
Yang Feixiang;Jiang Junqing;Luo Kekai(Department of Clincial Laborary,Dongfeng Hopial,Hubei University of Medicine,Hubei 442000,China)
出处
《医学研究杂志》
2020年第11期87-90,103,共5页
Journal of Medical Research
基金
湖北省教育厅指导性项目(B2017481)
湖北省教育厅大学生创新创业训练计划项目(201713249008)
十堰市科技局引导性科研项目(17Y44)
湖北医药学院学生科研基金资助项目。
关键词
人乳头瘤病毒
液基薄层细胞学检查
宫颈癌
宫颈上皮内瘤变
Human papillomavirus(HPV)
ThinPrep cytology test(TCT)
Cervical cancer
Cervical intraepithelial neoplasia
