摘要
目的:比较三种筛查方法在子宫颈癌及癌前病变诊断中的价值。方法:对191例宫颈病变患者进行高危型人乳头瘤病毒(HPV)检查、液基薄层细胞学(TCT)检查以及高危HPV联合TCT检查,以病理活检为金标准,分析比较其在子宫颈癌及癌前病变诊断中的价值。结果:191例患者病理活检结果显示宫颈上皮正常59例,CIN Ⅰ 21例,CIN Ⅱ 38例,CIN Ⅲ 35例,宫颈癌阳性38例。各年龄组CIN及宫颈癌阳性存在统计学差异(P<0.05),其中年龄为26～35岁组和36～45岁组CIN及宫颈癌阳性率明显大于46～55岁组和>55岁组(P<0.05)。高危HPV检查对子宫颈癌及癌前病变诊断灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为85.60%、79.66%、83.77%、90.40%和71.21%;TCT检查对子宫颈癌及癌前病变诊断灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为84.09%、88.14%、85.34%、94.07%和71.23%;联合检查对子宫颈癌及癌前病变诊断灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为93.18%、93.22%、93.19%、96.85%和85.94%。结论:高危HPV联合TCT检查可提高子宫颈癌及癌前病变诊断信效度。
Objective: To compare the diagnostic value of three screening methods in cervical cancer and precancerous lesions.Methods: 191 cases of patients with cervical lesions were given high-risk human papillomavirus (HPV) examination, Thinprep cytology test (TCT) examination, and high-risk HPV combined with TCT. The pathologic biopsy was taken as gold standard to analyze and compare the diagnostic value of the methods for cervical cancer and precancerous lesions. Results: The pathologic biopsy results of 191 patients showed that there were 59 cases of normal cervical epithelium, 21 cases of CIN I, 38 cases of CIN II, 35 cases of CIN III and 38 cases of positive cervical cancer. There were significant differences in the positive rates of CIN and cervical cancer in all age groups ( P <0.05), and the positive rates of CIN and cervical cancer in the 26-35-year-old group and the 36-45-year-old group were significantly higher than those in the 46-55-year-old group and the 55-year-old group ( P <0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in the diagnosis of cervical cancer and precancerous lesions were 85.60%, 79.66%, 83.77%, 90.40% and 71.21% respectively by high-risk HPV examination, and were 84.09%, 88.14%, 85.34%, 94.07% and 71.23% respectively by TCT examination, and were 93.18%, 93.22%, 93.19%, 96.85% and 85.94% respectively by combined examination.Conclusion:High-risk HPV combined with TCT can improve the reliability and validity of diagnosis for cervical cancer and precancerous lesions.
作者
蒋洪波
杨龙涛
周红荣
JIANG Hongbo;YANG Longtao;ZHOU Hongrong(Department of Gynecology, Shanghai Changning Maternal and Child Health Hospital(Shanghai 200051))
出处
《陕西医学杂志》
CAS
2019年第2期217-219,共3页
Shaanxi Medical Journal
关键词
高危型人乳头瘤病毒检查
液基薄层细胞学检查
子宫颈癌
癌前病变
筛查
对比研究
High-risk human papillomavirus examination
Thinprep cytology test
Cervical cancer
Precancerous lesions
Screen
Comparative study
