摘要
目的探讨高危型人乳头瘤病毒检测(HR-HPV)、液基细胞学检查(TCT)联合阴道镜下宫颈活检对宫颈癌前病变及宫颈癌的诊断价值.方法对1400例门诊宫颈癌筛查者资料进行分析.所有筛查者均行HR-HPV、TCT、阴道镜下宫颈活检及病理组织学检查.结果1400例筛查者接受TCT检查,322例为ASC-US及以上病变,阳性率为23.00%(322/1400).322例阳性进一步进行病理学检查,结果提示,ASC-US 124例,ASC-H 73例,LSIL 57例,HSIL 43例,SCC 25例.TCT、TCT+HR-HPV、TCT+阴道镜宫颈活检对于宫颈病变的阳性检出率分别为38.51%(124/322)、54.04%(174/322)、68.63%(221/322);TCT+HR-HPV与TCT+阴道镜宫颈活检阳性检出率高于单独使用TCT的阳性检出率,差异有统计学意义(P<0.05);而TCT+HR-HPV+阴道镜宫颈活检的阳性检测率最高,为76.71%(247/322),差异均具有统计学意义(P<0.05).HR-HPV联合阴道镜检查对于诊断ASC-US、ASC-H、LSIL、HSIL、SCC的灵敏度分别为95.42%、96.54%、98.24%、100.00%、100.00%,特异度分别为72.15%、75.33%、65.24%、41.35%、0.00%,其灵敏度和特异度均明显高于单独使用HR-HPV或阴道镜检查,差异有统计学意义(P<0.05).结论HR-HPV、TCT联合阴道镜下宫颈活检可显著提高临床上宫颈病变和宫颈癌的检出率,同时提高检测的灵敏度和特异度,对患者的早期诊断、早期治疗和改善预后具有重要意义.
Objective To investigate the diagnostic value of high-risk human papillomavirus(HRHPV),Thinprep liquid cytologic test(TCT),and colposcopy cervical biopsy for cervical precancerous lesions and cervical cancer. Methods The data of 1 400 outpatients with cervical cancer screening were analyzed. All patients underwent HR-HPV,TCT,colposcopy cervical biopsy,and histopathological examination.Results All patients received 1400 TCT examination,the results of 322 cases of patients shown as ASC-US and more severe lesions,positive rate was 23.00%(322/1 400). A further pathological examination was performed on the 322 positive patients,and the results indicated that 124 ASC-US,73 ASC-H,57 LSIL,43 HSIL,and 25 SCC. The positive detection rates of cervical lesions by TCT,TCT + HR-HPV,and TCT + colposcopy for cervical lesions were 38.51%(124/322),54.04%(174/322),and 68.63%(221/322),respectively. The positive detection rate of TCT + HR-HPV and TCT + colposcopy cervical biopsy was higher than TCT alone,the difference was statistically significant(P<0.05). The positive rate of TCT + HR-HPV + colposcopy cervical biopsy was the highest,being 76.71%(247/322),which was significantly higher than the other three groups,and the differences were diagnosis of ASC-US,ASC-H,LSIL,HSIL,and SCC was 95.42%,96.54%,98.24%,100.00%,and 100.00%,and the specificity was 72.15%,75.33%,65.24%,41.35%,0.00%,respectively,which were significantly higher than those using HR-HPV or colposcopy alone,and the differences were statistically significant(P<0.05). Conclusions HR-HPV and TCT combined with colposcopy for cervical biopsy can significantly improve the detection rate of cervical lesions and cervical cancer in the clinic,at the same time improve the sensitivity and specificity of detection,which is important for early diagnosis,treatment and Improve prognosis of patients.
作者
杨东斌
YANG Dongbin(Department of Pathology,the first peoples Hospital of Ningyang County,Ningyang,Shandong,China,271400)
出处
《分子诊断与治疗杂志》
2020年第7期944-947,共4页
Journal of Molecular Diagnostics and Therapy
关键词
TCT
HR-HPV
阴道镜
宫颈癌
宫颈癌前病变
筛查
准确率
漏诊率
TCT
HR-HPV
Colposcopy
Cervical cancer
Cervical precancerous lesions
Screening
Accuracy rate
Misdiagnosis rate
