摘要
目的探究液基细胞学(thinprep cytologic test,TCT)、弹性超声及阴道镜检查对宫颈癌癌前病变的预测效能。方法回顾234例宫颈癌前病变患者资料,所有患者均接受TCT、弹性超声及阴道镜检查,以宫颈组织病理学检测结果为“金标准”分析不同检测方法的预测价值。结果234例宫颈癌前病变患者包含宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)207例(88.46%),鳞状细胞癌(squamous cell carcinoma,SCC)27例(11.54%)。不同方法宫颈病变阳性检出率比较差异有统计学意义(P<0.05),以TCT、弹性超声、阴道镜三者联合检查阳性检出率最高,TCT单独检测阳性检出率最低。不同方法预测宫颈癌癌前病变风险的敏感度、特异度、准确率、阳性预测值、阴性预测值比较差异有统计学意义(P均<0.05),其中以三者联合检查敏感度最高,而阴道镜检查特异度、阳性预测值均最高,弹性超声联合阴道镜准确率、阴性预测值均最高,TCT检测敏感度、准确率、阳性预测值、阴性检测值均最低,TCT联合阴道镜检查特异度最低。结论TCT、弹性超声及阴道镜三者联合检查可提高CIN 2及以上宫颈癌癌前病变风险预测效能,但较弹性超声联合阴道镜检测无显著优势,临床可根据实际情况综合选择。
Objective To explore the predictive efficiency of Thinprep cytologic test(TCT),ultrasound elastography and colposcopy on precancerous lesions of cervical cancer.Methods The data of 234 patients with precancerous lesions of cervical cancer who were treated in the hospital were reviewed.All patients received TCT,ultrasound elastography and colposcopy,and the cervical histopathological examination was used as the"gold standard"to analyze the predictive value of different detection methods.Results There were 207 cases(88.46%)of cervical intraepithelial neoplasia(CIN)and 27 cases(11.54%)of squamous cell carcinoma(SCC)among 234 patients with precancerous lesions of cervical cancer.There was a statistical significance in the positive detection rate of cervical lesions by different methods(P<0.05),and the positive detection rate was the highest by combination of TCT,ultrasound elastography and colposcopy and was and the lowest by TCT alone.There were statistical differences in the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value among different methods for predicting the risk of precancerous lesions of cervical cancer(all P<0.05).The sensitivity was the highest in combination of the three,the specificity and positive predictive value were the highest in colposcopy,the accuracy rate and negative predictive value were the highest in ultrasound elastography combined with colposcopy,the sensitivity,accuracy rate,positive predictive value and negative detection value were the lowest in TCT,and the specificity was the lowest in TCT combined with colposcopy.Conclusion The combined detection of TCT,ultrasound elastography and colposcopy can improve the predictive efficiency on risk of of cervical precancerous lesions of CIN 2 and above,but it has no significant advantages over ultrasound elastography combined with colposcopy.It is necessary to make comprehensive selection according to the actual situation in clinical practice.
作者
王利想
石静静
李秋敏
WANG Lixiang;SHI Jingjing;LI Qiumin(Puyang Maternal and Child Health Hospital,Puyang,457000)
出处
《实用癌症杂志》
2024年第2期315-318,330,共5页
The Practical Journal of Cancer
关键词
液基细胞学
弹性超声
阴道镜
宫颈癌癌前病变
Thinprep cytologic test
Ultrasound elastography
Colposcopy
Precancerous lesions of cervical cancer
