摘要
目的评价超薄液基细胞学(TCT)和高危型人乳头瘤病毒(HR-HPV-DNA)检测在宫颈癌筛查中的诊断价值。方法对2010年2月至2012年3月本院妇科门诊患者已进行TCT及HC2-HPV-DNA检测的患者687例进行研究,患者均已做宫颈病理活检,以病理活检为金标准,按≥(宫颈上皮内瘤样变)CINⅠ级为阳性,同时以HPV-DNA检测的RLU/CO比值≥1.0诊断为阳性,TCT≥ASCUS为异常,分析TCT、HPV-DNA及两者联合检测结果对宫颈活检指征的分析。结果 TCT、HPV-DNA、TCT联合HPV作为诊断试验指标:灵敏度(76.5%、84.7%、72.0%),特异性(73.6%、52.7%、80.7%),阳性预测值(57.9%、45.1%、64.5%),阴性预测值(86.8%、88.3%、85.6%),诊断符合率(74.5%、62.7%、77.9%),Kappa值(0.46、0.30、0.51)。任一单种或联合检测方法的灵敏度和特异性差异有统计学意义(P<0.05),TCT和HPV-DNA联合检测有较高的阳性预测值,但三者的阴性预测值差异无统计学意义,符合率和Kappa值以联合检测方法最高,可靠性最好。结论 TCT联合HPV检测比HPV、TCT单一指标更有利于宫颈癌的早期筛查。
Objective To evaluate the value of liquid-based thin-layer cytological test （TCT） and high risk human papillomavirus （HR-HPV） detection in the screening of cervical cancer. Methods TCT and HC2-HPV-DNA were detected in 687 patients in our hospital from February 2010 to March 2011. Cervical biopsy was taken as the gold standard, ≥CIN I （cervical intraepithelial neoplasia） was regarded as positive, the ratio of RLU/CO≥ 1.0 inHC2-HPV-DAN test as positive, TCT~〉ASCUS in TCT test as abnormal. The value of TCT detection, HPV-DNA de- tection and co-test of TCT and HPV-DNA were analyzed. Results The results for TCT test, HPV-DNA test and co-test of TCT and HPV-DNA were as follows： sensitivity （76.5%, 84.7%, 72.0%）, specificity （73.6%, 52.7%, 80.7%）, positive predictive value （57.9%, 45.1%, 64.5%）, negative predictive value （86.8%, 88.3%, 85.6%）, diagnostic accor- dance rate （74.5%, 62.7%, 77.9%）, Kappa value （0.46, 0.30, 0.51）. There were significant differences among sensitivi- ty and specificity of TCT test, HC2 test and co-test （P〈0.05）. The co-test had higher positive predictive value than TCT test, HC2 test, but with no statistically significant difference. The diagnostic accordance rate and Kappa value of co-test was the highest, with the best reliability. Conclusion Co-test of TCT and HPV-DNA is more conducive for the early screening of cervical cancer than TCT test and HC2 test.
出处
《海南医学》
CAS
2012年第24期100-102,共3页
Hainan Medical Journal
关键词
液基细胞学
高危型人乳头瘤病毒
宫颈癌
活检
敏感性
特异性
Thinprep cytology
High risk human papillomavirus
Cervical cancer
Biopsy
Sensitivity
Specificity
作者简介
龙华泉（1968-），男，广东省江门市人，副主任技师，学士。
