摘要
目的 探讨宫颈癌筛查系统（TS）作为新型宫颈病变筛查方法的诊断价值.方法 选取2013年12月至2014年11月就诊于解放军总医院妇科门诊阴道镜室的患者218例,以组织病理学为诊断金标准,比较TS、高危型人乳头瘤病毒（Hr-HPV）及联合应用的诊断效果.结果 （1） 218例患者中,Hr-HPV阳性193例,占88.5％.TS阳性94例,占43.1％.病理学宫颈上皮内瘤变（CIN）1＋112例,CIN2＋ 71例,分别占51.4％和32.6％.（2） HPV诊断灵敏度98.2％,特异度21.7％;TS诊断灵敏度51.8％,特异度66.0％.（3） TS分流非典型鳞状细胞（ASC-US）的灵敏度43.9％,特异度65.7％,诊断符合率53.9％;分流液基细胞学（TCT）≥非典型鳞状上皮倾向高级别病变（ASC-H）的灵敏度56.3％,特异度66.2％,诊断符合率61.3％;HPV分流TCT≥ASC-H的灵敏度97.2％,特异度32.4％,诊断符合率64.8％.结论 HPV检测的灵敏度较高,TS的特异度较高,二者的分流价值有待扩大样本量进一步分析.
Objective To investigate the diagnostic value of TruScreen （TS） as a novel option for cervical lesions screening.Methods A total of 218 cases were selected between 2013 December and 2014 November from outpatients of the Department of Gynecology,PLA General Hospital.Using histopathology as the gold standard for diagnosis,the diagnostic efficacy of TS was compared with that of high-risk human papillomavirus （Hr-HPV） test.Results （1） In 218 patients,there were 193 Hr-HPV positive cases accounting for 88.5%,94 TS positive cases accounting for 43.1%.According to the histopathology,there were 112 cases of cervical intraepithelial neoplasia （CIN） 1 ＋,71 cases of CIN2＋,accounting for 51.4% and 32.6%,respectively.（2） The sensitivity of Hr-HPV was 98.2% and specificity was 21.7%.The sensitivity of TS was 51.8% and specificity 66.0%.（3） Sensitivity of TS for triaging cases of atypical squamous cells of undetermined signification （ASC-US） was 43.9%,specificity 65.7%,diagnostic accordance rate 53.9%.Those indexes for triaging cases of equivalent or more than atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion （ASC-H） were 56.3%,66.2% and 61.3%.With regard to Hr-HPV test,those indexes for triaging cases of equivalent or more than ASC-H were 97.2%,32.4% and 64.8%.Conclusions Hr-HPV test shows higher sensitivity while TruScreen shows higher specificity for cervical lesions screening.More studies with larger sample size are still needed to evaluate which method is a better triage tool.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第29期2379-2381,共3页
National Medical Journal of China
基金
解放军总医院临床科研扶持基金（2013FC-ZHCG-1005）
关键词
宫颈上皮内瘤变
初善仪
分流
诊断
Cervical intraepithelial neoplasia
TruScreen
Triage
Diagnosis
