摘要
目的分析高危型人乳头瘤病毒(HR-HPV)检测和液基薄层细胞学(TCT)检查与病理学诊断结果关系,探讨单一检测和联合检测对宫颈癌及癌前病变的诊断性能。方法收集2019年1月至2021年3月我院妇科就诊并行阴道镜宫颈活检的女性患者1280例,均进行15种型别的HR-HPV核酸检测和TCT检查,以阴道镜下宫颈活检的病理学诊断结果为标准,评估对宫颈癌及癌前病变的诊断筛查效能。结果1280例患者宫颈活检病理学诊断结果中,病理学结果阳性576例,阳性率45.00%;随着病理学诊断结果分级的升高,TCT检查阳性率逐渐增高,且具有显著相关性,SCC和CINⅢ级的TCT阳性率显著高于其他3组,CINⅡ级的TCT阳性率显著高于炎症组和CINⅠ级,CINⅠ级的TCT阳性率显著高于炎症组;随着病理学诊断结果分级的升高,HR-HPV检测阳性率逐渐增高,且具有显著相关性,SCC组阳性率显著高于其他4组,CINⅢ级的阳性率显著高于炎症组和CINⅠ级,炎症组的阳性率显著低于其他4组;HR-HPV检测灵敏度高于TCT检查,TCT检查特异性高于HR-HPV单一检测和联合检测,联合检测灵敏度和阴性预测值高于单一检测,结果比较差异有统计学意义。结论HR-HPV和TCT单一检测不仅适用于宫颈癌和癌前病变的初筛,还可以对宫颈病变分级程度的评估提供一定的依据;联合检测对宫颈癌和癌前病变的筛查诊断效能高于单一检测,可提高HR-HPV检测的特异性、降低其误诊率,提高TCT检查的灵敏度、降低其漏诊率。
Objective To analyse the relationship between high-risk human papillomavirus(HR-HPV) test and Thinprep cytologic test(TCT)with pathological diagnosis results, and to explore the diagnostic performance of single test and combined test for cervical cancer and precancerous lesions.Methods A total of 1 280 female patients who received colposcopy cervical biopsy from January, 2019 to March, 2021 in the Gynecological Department of our hospital were collected for the study. All patients underwent 15 types of HR-HPV nucleic acid tests and TCT examinations. The result of physical diagnosis was the standard to evaluate the diagnostic and screening efficacy of cervical cancer and precancerous lesions.Results Among 1,280 patients with pathological diagnosis of cervical biopsy, 576 cases were positive with the positive rate of 45.00%;With the increase of pathological diagnosis grade, the positive rate of TCT increased gradually, and there was a significant correlation. The positive rate of TCT in SCC and CIN Ⅲ was significantly higher than that in other three groups.The positive rate of TCT in CIN Ⅱ was significantly higher than that in inflammatory group and CIN Ⅰ, and the positive rate of TCT in CIN Ⅰ was significantly higher than that in inflammatory group;With the increase of pathological diagnosis results, the positive rate of HR-HPV gradually increased with a significant correlation. The positive rate of the SCC group was significantly higher than that in other four groups. The positive rate of CIN Ⅲ was significantly higher than that in the inflammation group and CIN Ⅰ, and the positive rate of inflammation group was significantly lower than that in other four groups;The sensitivity of the HR-HPV test was higher than that of the TCT test, while the specificity of the TCT test was higher than the HR-HPV single test and the combined test, and the sensitivity and negative predictive value of the combined test were higher than the single test. All the comparisons of the results were statistically significant.Conclusion The single test of HR-HPV and TCT is not only suitable for the primary screening of cervical cancer and precancerous lesions, but can also provide a reference basis for the evaluation of the grading degree of cervical lesions;The combined test has a higher diagnostic efficiency than single test for screening of cervical cancer and precancerous lesions, which can increase the specificity of HR-HPV test, reduce its misdiagnosis rate, increase the sensitivity of TCT test, and reduce its missed diagnosis rate.
作者
张淑艳
武鑫瑞
王君喆
何岗贤
刘杰
ZHANG Shuyan;WU Xinrui;WANG Junzhe;HE Gangxian;LIU Jie(Department of Medical Technology Support,Jingdong Medical District of Chinese PLA General Hospital,Beijing 100191,China;Department of Laboratory Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China)
出处
《标记免疫分析与临床》
CAS
2022年第6期958-961,1051,共5页
Labeled Immunoassays and Clinical Medicine
基金
北京市科委生物医药—首都市民健康培育项目(编号:Z161100000116078)。
