摘要
目的:分析人乳头瘤病毒(HPV)分型、液基细胞学检查(LBC)与阴道镜活检对宫颈癌前病变的早期诊断的准确性。方法:选取2020年3月—2022年3月于中山大学孙逸仙纪念医院行妇科细胞学检查的妇女983例为观察对象,观察对象均行HPV分型、LBC及阴道镜活检,以阴道镜活检为金标准,对比LBC、HPV分型诊断与阴道镜活检诊断的一致性。计算LBC、HPV分型单一及联合诊断癌前病变的灵敏度、特异度。结果:983例患者均行阴道镜活检,诊断癌前病变患者152例。LBC诊断癌前病变患者142例(14.45%),LBC诊断癌前病变的灵敏度、特异度分别为82.89%、98.07%;采用一致性检验法检测LBC诊断与阴道镜活检诊断癌前病变的Kappa为0.786,两者一致性较好,差异具有统计学意义(P<0.05)。采用HPV分型检查诊断癌前病变的灵敏度、特异度分别为67.76%、97.47%;采用一致性检验法检测HPV分型诊断与阴道镜活检检查诊断癌前病变的Kappa为0.726,两者一致性一般,差异具有统计学意义(P<0.05)。采用LBC联合HPV分型检查诊断癌前病变的灵敏度、特异度分别为95.39%、91.58%;采用一致性检验法检测LBC联合HPV分型检查诊断与阴道镜活检诊断癌前病变的Kappa为0.815,两者一致性极好,差异具有统计学意义(P<0.05)。结论:健康查体中应用HPV分型、LBC有助于早期筛查宫颈癌前病变,且两者联合诊断价值更高,有助于早期诊断并及早介入治疗,降低宫颈癌发生率、改善患者预后。
Objective To analyze the accuracy of human papilloma virus(HPV)typing,liquid-based cytology(LBC)and colposcopic biopsy for the early diagnosis of cervical precancerous lesions.Methods From March 2020 to March 2022,983 women who were examined in Sun Yat-sen Memorial Hospital,Sun Yat-sen University health check-up center were selected as observation subjects,and all observation subjects underwent HPV typing,LBC and colposcopic biopsy,and LBC,HPV typing and colposcopic biopsy were detected by the consistency test using colposcopic biopsy examination as the gold standard.The sensitivity and specificity of single and combined diagnosis of precancerous lesions by LBC and HPV typing were detected.Results In this experiment,983 patients underwent colposcopic biopsy,and 142 of them(14.45%)were diagnosed as precancerous lesions.The sensitivity and specificity of LBC in diagnosing precancerous lesions using the four-grid table method were 82.89%and 98.07%,respectively.0.786,with good agreement between them(P<0.05).The sensitivity and specificity of HPV typing test were 67.76%and 97.47%,respectively;The Kappa of HPV typing test and colposcopic biopsy test using the concordance test was 0.726,which was generally consistent(P<0.05).The sensitivity and specificity of LBCcombined with HPV typing for the diagnosis of precancerous lesions were 95.39%and 91.58%,respectively;The Kappa of HPV typing and colposcopic biopsy examination for the diagnosis of precancerous lesions using the consistency test was 0.815,with excellent agreement between the two(P<0.05).Conclusion The application of HPV typing and LBC in health checkups helps to screen cervical precancerous lesions at an early stage,and the combined diagnostic value of the two is high,which helps to diagnose early and intervene early for treatment,and reduce the incidence of cervical cancer and improve the prognosis of patients.
作者
何贵
刘淑园
萧晓琴
HE Gui;LIU Shuyuan;XIAO Xiaoqin(Cell and Molecular Diagnostic Center,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong510289,China;Guangzhou Heshi Biotechnology Co.,LTD,Guangzhou,Guangdong 510000,China)
出处
《医药前沿》
2023年第13期1-3,共3页
Journal of Frontiers of Medicine
