摘要
目的探讨超薄液基细胞学(TCT)和高危人乳头瘤病毒DNA聚合酶链反应(HR-HPV DNA PCR)检测在宫颈癌及其癌前病变筛选中的价值。方法选取2008年2月至2013年2月查体女工中拟诊宫颈癌需要进行病理活检的480例患者进行TCT和HR-HPV DNA PCR检测,并与病理结果对照,比较TCT、HR-HPV DNA PCR及其联合检测的特异度、灵敏度、阳性预测值、阴性预测值和准确度。结果 TCT、HR-HPV DNA PCR及其联合检测的特异度分别为65.6%、58.8%和92.1%,灵敏度分别为75.4%、85.7%和69.5%,阳性预测值分别为56.6%、44.6%和65.8%,阴性预测值分别为86.8%、85.4%和88.9%,准确度分别为73.4%、60.4%和81.2%。HR-HPV DNA PCR的灵敏度显著高于TCT和联合检测(P<0.05),联合检测的特异度、准确度均显著高于TCT和HR-HPV DNA PCR(P<0.05),TCT和HR-HPV DNA PCR的阳性预测值显著低于联合检测(P<0.05),三者阴性预测值差异无统计学意义(P>0.05)。结论 TCT、HR-HPV DNA PCR均能有效筛选宫颈癌及其癌前病变,而联合检测则能使两种检查优势互补,提高诊断的准确度。
Objective To compare the value of thin liquid-based cytology （TCT）, high-risk human papillomavirus DNA by polymerase chain reaction （ HR-HPV DNA PCR） and its joint detection in screening for cervical cancer and precancerous lesions. Methods Examination for 480 cases to be diagnosed with cervical cancer needed for biopsy in our hospital from February 2008 to February 2013 were treated of TCT and HR-HPV DNA PCR testing, and were compared with the pathological findings, then compare specificity, sensitivity, positive predictive value, negative predictive value and accuracy of TCT, HR- HPV DNA PCR and joint detection. Results Specificity of TCT, HR-HPV DNA PCR and joint detection were 65.6% , 58. 8% , 92.1% , sensitivity were 75.4% , 85.7% , 69.5% , positive predictive value were 56. 6% , 44. 6% 65.8% , and negative predictive values ？？ were 86. 8% , 85.4% , 88.9% , and accuracy were 73.4% , 60. 4% , 81.2%. Sensitivity of HR-HPV DNA PCR was significantly higher than TCT, joint detection （P 〈0. 05）; specificity and accuracy of joint detection were significantly higher than TCT, HR- HPV DNA PCR （ P 〈 0. 05 ） ; positive predictive value of TCT, HR-HPV DNA PCR were significantly lowere than combined detection （ P 〈 0. 05 ） ; there were no significantly difference in negative predictive values （P 〉 0. 05 ）. Conclusion TCT, HR-HPV DNA PCR can effectively screen cervical cancer and precancerous lesions, and joint detection is possible to make complementary advantages in these two kinds of methods to improve diagnostic accuracy.
出处
《中国肿瘤临床与康复》
2014年第5期528-530,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
