摘要
目的探讨液基薄层细胞学(thinprep cytologic test,TCT)技术、高危型人乳头瘤病毒(humanpapiloma virus,HPV)和DNA倍体分析在宫颈癌筛查中的应用价值。方法分析2017年10～12月首都医科大学附属北京妇产医院397例阴道镜下宫颈组织学活检患者,以病理学诊断结果为金标准,宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ及以上为阳性,计算TCT、高危型HPV及DNA倍体3种检测方法在宫颈癌筛查中的敏感性、特异性、阳性预测值、阴性预测值、病理符合率,同时比较三者统计学差异。结果在397例患者中,114例病理检查结果为CINⅡ及以上,其中CINⅡ57例、CINⅢ42例、宫颈癌15例。以TCT、高危型HPV和DNA异倍体作为观察指标,发现CINⅡ+的敏感性分别为:93. 00%(106/114)、93. 9%(107/114)、65. 80%(75/114)。前两者比较差异无统计学意义(P> 0. 05),与后者比较差异有统计学意义(P <0. 05)。特异性分别为:32. 20%(91/283)、18. 70%(53/283)、95. 40%(270/283),3组两两比较差异有统计学意义(P<0. 05)。3组阳性预测值分别为:35. 60%、31. 80%、85. 20%,前两者比较差异无统计学意义(P> 0. 05),与后者比较差异有统计学意义(P <0. 05)。阴性预测值分别为:91. 90%、88. 30%、87. 40%,3组两两比较差异无统计学意义(P> 0. 05)。病理诊断符合率分别为49. 60%(197/397),40. 30%(160/397),86. 90%(345/397),3组两两比较差异有统计学意义(P <0. 05)。结论 3种检测方法在宫颈癌筛查中:TCT及高危型HPV的敏感性最高,DNA倍体分析在特异性、阳性预测值、病理诊断符合率最佳。
Objective To investigate the clinical value of thinprep cytologic test(TCT),the test of high-risk human papillomavirus(HPV) and DNA ploidy analysis in the screening of cervical cancer.Methods A total of 397 colposcopy cases of cervical biopsy were sampled,the pathological diagnosis was taken as the gold standard of diagnosis(CINⅡand above were positive).The sensitivity,specificity,positive predictive value,negative predictive value,and pathological coincidence rate of TCT,high-risk HPV test and DNA ploidy were calculated in the screening for cervical cancer.The statistical differences were also calculated.Results Among the tested 397 patients,114 cases were CINⅡ and above,which includes 57 cases of CINⅡ,42 cases of CINⅢ and 15 cases of cervical cancer.TCT positive individuals,high-risk HPV positive individuals and DNA ploidy positive individuals were regarded the observe measures.The sensitivity of CINⅡand above were 93.00 %(106/114),93.90 %(107/114) and 65.80 %(75/114) respectively.Comparisons among the first two groups were not statistically significant(P>0.05),while comparision with the last group were statistically significant(P<0.05).The specificity was 32.20 %(91/283),18.70 %(53/283) and 95.40 %(270/283) respectively.The differences between every two groups were statistically significant(P<0.05).The positive predictive values of three groups were 35.60 %,31.80 % and 85.20 % respectively.Comparing among the first two groups were not statistically significant(P>0.05),while compared with the last group the differences were statistically significant(P<0.05).The negative predictive values were 91.90 %,88.30 % and 87.40 % respectively.Each group compared with two other groups were not statistically significant(P>0.05).The pathological coincidence rates were 49.60 %(197/397),40.30 %(160/397),86.90 %(345/397) respectively.Every group compare with two other groups were statistically significant(P<0.05).Conclusion TCT and high-risk HPV are more sensitivity for screening for cervical cancer,and the DNA ploidy analysis shows better results in specificity,positive predictive valueand pathological coincidence rate.
作者
晏燕
孔为民
李霞
YAN Yan;KONG Wei-min;LI Xia(Department of Gynecologic Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,P.R. China;Department of Obstetrics and Gynecologic,New Century Women's and Children's Hospital,Chengdu Sichuan 610000,P. R.China)
出处
《中国计划生育和妇产科》
2019年第2期66-69,共4页
Chinese Journal of Family Planning & Gynecotokology
作者简介
晏燕,首都医科大学研究生在读(2014年2月至今),副主任医师,主要研究方向为妇科肿瘤;通讯作者,E-mail:kwm1967@163.com.
