摘要
目的研究液基薄层细胞学检测(TCT)、人乳头状瘤病毒(HPV)联合阴道镜检测在早期宫颈癌及癌前病变筛查中的应用价值。方法回顾分析2019年4月-2021年12月在我院进行宫颈疾病筛查的480例疑似宫颈病变,行TCT和HPV筛查患者的临床资料,其中有453例筛查异常行阴道镜检查。观察TCT、HPV以及TCT+HPV检测阳性率、不同检测方法(TCT+HPV+阴道镜、阴道镜、TCT、HPV)诊断准确率、敏感度和特异度,以及不同检测方法对早期宫颈癌及癌前病变筛查诊断准确率与病理结果的一致性。结果TCT+HPV检测阳性率均高于TCT、HPV,但TCT与HPV比较,差异无统计学意义(P>0.05);TCT+HPV+阴道镜联合诊断准确率均高于TCT、HPV、阴道镜,且阴道镜高于TCT、HPV,HPV高于TCT(P<0.05);TCT+HPV+阴道镜检测敏感度、特异度均高于阴道镜、TCT、HPV,且阴道镜高于TCT、HPV,HPV检测敏感度高于TCT检测,TCT检测特异度高于HPV检测(P<0.05);TCT+HPV+阴道镜对早期宫颈癌及癌前病变筛查诊断准确率与病理结果具有高度一致性,且一致性高于TCT、HPV以及阴道镜检测(P<0.05)。结论TCT、HPV联合阴道镜检测在早期宫颈癌及癌前病变筛查中具有重要的价值,可提高诊断准确性,有效预防漏诊和误诊,可为早期治疗和预防宫颈癌提供可靠的参考依据。
Objective To study the application value of thinprep cytologic test(TCT),human papillomavirus(HPV)combined with colposcopy in the screening of early-stage cervical cancer and precancerous lesions.Methods The clinical data of 480 patients with suspected cervical lesions who underwent TCT and HPV screening in our hospital from April 2019 to December 2021 were retrospectively analyzed.Among them,453 patients with abnormal screening underwent colposcopy.The positive rates of TCT,HPV and TCT+HPV detection,the diagnostic accuracy,sensitivity and specificity of different detection methods(TCT+HPV+colposcopy,colposcopy,TCT,HPV),and the consistency between the diagnostic accuracy and pathological results of different detection methods for early-stage cervical cancer and precancerous lesions were observed.Results The positive rate of TCT+HPV was higher than that of TCT and HPV,but there was no significant difference between TCT and HPV(P>0.05).The diagnostic accuracy of TCT+HPV+colposcopy was higher than that of TCT,HPV and colposcopy,and colposcopy was higher than TCT and HPV,HPV was higher than TCT(P<0.05).The sensitivity and specificity of TCT+HPV+colposcopy were higher than those of colposcopy,TCT and HPV,and colposcopy was higher than TCT and HPV,while the sensitivity of HPV detection was higher than that of TCT detection,and the specificity of TCT detection was higher than that of HPV detection(P<0.05).The accuracy of TCT+HPV+colposcopy in the screening and diagnosis of early cervical cancer and precancerous lesions was highly consistent with the pathological results,and the consistency was higher than that of TCT,HPV and colposcopy(P<0.05).Conclusion TCT,HPV combined with colposcopy have important value in the screening of early-stage cervical cancer and precancerous lesions,which can improve the diagnostic accuracy,effectively prevent missed diagnosis and misdiagnosis,and provide reliable reference for early treatment and prevention of cervical cancer.
作者
李明明
赵芳
张亚青
LI Ming-ming;ZHAO Fang;ZHANG Ya-qing(Physical Examination Center,Beijing Mentougou District Maternal and Child Health Hospital,Beijing 102300,China)
出处
《医学信息》
2023年第13期103-106,共4页
Journal of Medical Information
关键词
TCT
HPV
阴道镜
早期宫颈癌
癌前病变
TCT
HPV
Colposcopy
Early-stage cervical cancer
Precancerous lesions
