摘要
目的探讨液基薄层液基细胞学（TCT）、人乳头瘤病毒高危型杂交捕获（HR．HPV．HC2）联合检测筛查宫颈上皮内瘤样病变（CIN）及预警其术后复发临床价值。方法对2009至2011年嘉兴市妇幼保健院的725例疑似CIN患者同时进行TCT、HR．HPV—HC2检测和多点锥切活组织检查确诊。对203例CINⅡ～Ⅲ级患者行宫颈leep术或冷刀锥切术，术后进行TCT、HR．HPV．HC2和多点锥切活检随访。分析TCT、HR—HPV—HC2单独和联合检测筛查CIN和预警其术后复发的灵敏度。结果TCT、HC2单独检测初筛诊断CIN的漏诊率、误诊率分别为19．23％（40／208）、12．50％（12／96）和48．15％（156／324）、74．07％（240／324），敏感性、特异性分别为90．02％、97．01％和51．85％、17．76％。TCT、HC2联合检测满足其一即初筛诊断CIN的敏感性98．25％，漏诊率1．75％，阴性预测值89．70％；二者均需满足才能初筛诊断CIN的特异性58．95％，阳性预测值72．80％。TCT、HC2单独检测预警CIN术后6个月复发特异性80％左右；二者联合检测且均需满足才能诊断CIN术后复发，3个月特异性98．27％，6个月阴性预测值98．75％；二者联合检测且只需满足其一即诊断CIN术后复发的3、6个月敏感性均97．22％，6个月阴性预测值99．17％。结论TCT、HC2联合检测，可明显提高CIN预警及术后复发的敏感性和特异性。
Objective To evaluate the clinical significance of combined detection of TCT and HR- HPV-HC2 assay in the screening and recurrence prediction of CIN. Methods A total of 725 patients with suspected cervical abnormalities received TCT plus HR-HPV-HC2 detection and histopathological examinations. 203 CINⅡ～Ⅲ patients received TCT and HC2 detection and histopathological examinations after treated with loop electrosurgical excision procedure or cold knife conization operation. The results of pathological examinations were gold standard. The sensitivity and specificity of TCT, HR-HPV-HC2 and TCT plus HR-HPV-HC2 were analyzed. Results The missed diagnosis and misdiagnosis rate of TCT and HC2 alone were 19. 23%, 12. 50% and 48. 15%, 74. 07% and sensitivity and specificity 90.02%, 97. 01% and 51.85%, 17.76% respectively. The sensitivity, missed diagnosis rate and negative predictive value were 98. 25% , 1.75% and 89.70% when TCT or specificity and positive predictive value were 58.95% HR-HPV-HC2 met the CIN diagnostic criteria. The and 72. 80% when TCT and HR-HPV-HC2 met the CIN diagnostic criteria. The specificity of TCT or HR-I-IPV-HC2 alone was 80% for the prediction of recurrence at Month 6 postoperation. The specificity of TCT plus HR-HPV-HC2 was 98.27% for the prediction of recurrence at Month 3 postoperation and the negative predictive value was 98.75% at Month 6 postoperation. The sensitivity of TCT or HR-HPV-HC2 was 97.22% for the prediction of recurrence at Month 3/6. And the negative predictive value was 99. 17% at Month 6 postoperation. Conclusion The combined detection of TCT and HR-HPV-HC2 may improve the sensitivity and specificity of CIN and the predication of its postoperative recurrence.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第35期2503-2505,共3页
National Medical Journal of China
基金
基金项目：嘉兴市2008年度科技计划（2008AY2035）
关键词
细胞学技术
人乳头瘤病毒
宫颈上皮内瘤样病变
Cytological techniques
Human papillomavirus
Cervical intraepithelial neoplasia
