摘要
目的探讨高危型HPV与DNA定量、TCT及其联合检测在宫颈癌及癌前病变中的诊断价值。方法选择2012年8月-2014年2月来本院妇科检查的患者246例,用PCR-反向杂交检测HPV、染色法检测DNA定量、TCT检测,三项指标任一阳性者行阴道镜取活检,以病理诊断为金标准,Logistic回归联合预测概率的ROC曲线下面积,对单一及组合方式的敏感性、特异性进行比较分析。结果 HPV+DNA、TCT+DNA、TCT+HPV组合模式Logistic回归曲线联合预测概率(Pre)曲线下面积分别为0.954、0.898、0.727,HPV+DNA、TCT+DNA、TCT+HPV并联诊断宫颈癌前病变的敏感度分别为96.4%(134/139)、87.8%(122/139)、89.2%(124/139),3种组合敏感度比较差异有统计学意义(χ2=7.355,P<0.05),其中HPV+DNA组合与TCT+HPV组合以及TCT+DNA组合分别比较(χ2=5.388,P<0.05;χ2=7.108,P<0.017),3种组合特异度分别为59.8%(64/107)、59.8%(64/107)、60.7%(65/107)(χ2=0.554,P=0.758>0.05),差异无统计学意义。结论 HPV+DNA、TCT+DNA、TCT+HPV 3种组合均可作为宫颈癌前病变的筛查指标,但HPV+DNA组合的筛查灵敏度更高。
Objective To investigate the diagnostic value of high risk HPV and DNA quantification,thinprep cytologic test（ TCT） and its combined detection in the precancerosis and cervical carcinoma. Methods 246 cases of gynecological examination in our hospital from August 2012 to February 2014 were selected. HPV was detected by PCR- reverse hybridization,DNA quantification was detected by staining method,TCT test,the patients were biopsied by colposcopy whose one of three indicators was positive and the pathological diagnosis was used ad the gold standard. Using the area under the ROC curve（ AUC） of Logistic regression combined prediction probability compared the sensitivity and specificity of the single and combined ways. Results The aera of ROC curve of HPV ＋ DNA,TCT ＋ DNA,TCT ＋ HPV combined mode were 0. 954,0. 898,0. 727 respectivily,which were calculated with Logistic regression combined prediction probability. The parallel combinition sensitivity of HPV ＋ DNA,TCT ＋ DNA,TCT ＋ HPV was 96. 4%（ 134 /139）,87. 8%（ 122 /139）,89. 2%（ 124 /139）. The sensitivity differences of the three combination had statistical significance（ χ2= 7. 355,P〈0. 05）. The combination of HPV ＋ DNA,TCT ＋ HPV and TCT ＋DNA were compared（ χ2= 5. 388,P〈0. 05 and χ2= 7. 108,P〈0. 017）,the specificity of three kinds of combination were59. 8%（ 64 /107）,59. 8%（ 64 /107）,60. 7%（ 65 /107）（ χ2= 0. 554,P = 0. 758〉 0. 05） respectivily. The differences had no statistical significance. Conclusion Three kinds of combination,HPV ＋ DNA,TCT ＋ DNA,TCT ＋ HPV,can be used as the screening index of cervical precancerous lesions,but the sensitivity of HPV ＋ DNA combination is higher.
出处
《中国卫生检验杂志》
CAS
2015年第16期2716-2719,共4页
Chinese Journal of Health Laboratory Technology
基金
吴阶平医学基金会肝病医学部科研基金(2010-ZD-19)
四川省卫生厅科研课题(120294)
