摘要
目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA与液基薄层细胞学检查(TCT)联合检测在宫颈癌早期病变筛查中的价值。方法选择2017-06-12-2020-06-08濮阳市安阳地区医院检查的136例宫颈癌患者作为研究对象,所有患者阴道镜下做宫颈刮片,并进行HPV E6/E7 mRNA与TCT检测。记录检查结果,将病理组织活检结果作为金标准,计算单独HPV E6/E7 mRNA、TCT与联合检查宫颈癌的阳性检出率、诊断特异度与灵敏度,经一致性检验,对比单独TCT、HPV E6/E7 mRNA检测及联合检查与病理结果的一致性情况。结果TCT与HPV E6/E7 mRNA单独、联合检出宫颈癌病变分别为112例、118例、132例,阳性率为82.35%、86.76%、97.06%。TCT与HPV E6/E7 mRNA单独检测的阳性率比较,差异无统计学意义(χ^(2)=1.014,P=0.314),联合检测的阳性率高于TCT(χ^(2)=15.925,P<0.001)和HPV E6/E7 mRNA(χ^(2)=9.693,P=0.002)单独检测。联合检测诊断宫颈癌早期病变的灵敏度(95.69%)高于TCT(77.59%,χ^(2)=12.305,P<0.001)和HPV E6/E7 mRNA(81.90%,χ^(2)=11.131,P=0.001);联合检测的特异度(60.00%)与TCT(50.00%)和HPV E6/E7 mRNA(60.00%)单独检测对比差异无统计学意义,χ^(2)=0.404,P=0.525;TCT和HPV E6/E7 mRNA单独检测与病理检查结果的一致性较差(Kappa值分别为0.207和0.330均P<0.001),联合检测与病理检查结果的一致性较好(Kappa=0.594,P<0.001)。结论HPV E6/E7 mRNA联合TCT检测与单独检测诊断宫颈癌早期病变的特异度无显著差异,但联合检测的灵敏度较高,可提高宫颈癌早期病变的阳性检出率,且与病理检查的一致性较好,诊断价值优,可为临床治疗提供指导依据。
Objective This study investigated the value of human papilloma virus(HPV)E6/E7 mRNA combined with thinprep cytologic test(TCT)in screening early cervical cancer lesions.Methods A total of 136 patients with cervical cancer were selected as research objects from June 12,2017 to June 8,2020 in Anyang District Hospital of Puyang City.All patients underwent cervical scraping under colposcopy,and HPV E6/E7 mRNA and TCT were detected.The positive detection rate,diagnostic specificity and sensitivity of HPV E6/E7 mRNA and TCT alone and combined with cervical cancer were calculated,and the consistency of TCT alone and HPV E6/E7 mRNA combined with TCT and pathological results were compared after consistency test.Results TCT and HPV E6/E7 mRNA were detected in 112 cases,118 cases and 132 cases,respectively.The positive rates were 82.35%,86.76%and 97.06%.There was no significant difference in the positive rate between TCT and HPV E6/E7 mRNA alone(χ^(2)=1.014,P=0.314),and the positive rate of combined detection was higher than that of TCT(χ^(2)=15.925,P<0.001)or HPV E6/E7 mRNA alone(χ^(2)=9.693,P=0.002).The sensitivity of combined detection(95.69%)was higher than that of TCT(77.59%,χ^(2)=12.305,P<0.001)or HPV E6/E7 mRNA(81.90%,χ^(2)=11.131,P=0.001).The specificity of combined detection(60.00%)was not statistically significant compared with TCT(50.00%)or HPV E6/E7 mRNA(60.00%)alone(χ^(2)=0.404,P=0.525).The consistency between TCT or HPV E6/E7 mRNA and pathological examination was poor(Kappa was 0.207,0.330,both P<0.001),while the consistency between TCT or HPV E6/E7 mRNA and pathological examination was good(Kappa=0.594,P<0.001).Conclusions The specificity of HPV E6/E7 mRNA combined with TCT has no significant difference with that of TCT alone in the diagnosis of early cervical cancer lesions,but the sensitivity of combined detection is high,which can improve the positive detection rate of early cervical cancer lesions,and has good consistency with pathological examination and excellent diagnostic value,which can provide
作者
李美美
李浩
訾瑞峰
LI Mei-mei;LI Hao;ZI Rui-feng(Department of Laboratory Medicine,Anyang District Hospital,Anyang 455000,China;Department of Laboratory Medicine,Anyang Cancer Hospital,Anyang 455000,China)
出处
《社区医学杂志》
CAS
2021年第21期1285-1288,共4页
Journal Of Community Medicine
