宫颈癌筛查风险评估量表在体检人群宫颈癌及高度鳞状上皮内病变筛查中的应用

Application of the Cervical Cancer Screening Risk Assessment Scale to the screening of cervical cancer and high-grade squamous intraepithelial lesion in the population undergoing health check-up

目的 探讨宫颈癌筛查风险评估量表(CSRAS)在体检人群宫颈癌及高度鳞状上皮内病变(HSIL)筛查中的应用价值。方法 回顾性分析宫颈液新柏氏液基细胞学检查(TCT)和/或人乳头瘤病毒(HPV)检查结果异常,并行阴道镜下宫颈组织活检的195例患者的临床资料和体检数据。采用Kappa一致性检验分析TCT法、HPV-DNA法、TCT联合HPV-DNA法、CSRAS法(量表法)与病理检查结果的一致性,比较量表法与TCT法、HPV-DNA法、TCT联合HPV-DNA法筛查宫颈癌及HSIL的效能。结果 量表法与病理检查的结果基本一致(Kappa值=0.480,P<0.05),而TCT法、HPV-DNA法、TCT并联HPV-DNA法、TCT串联HPV-DNA法与病理检查结果的一致性较差(Kappa值<0.4)。量表法筛查宫颈癌及HSIL的灵敏度为59.46%,低于TCT并联HPV-DNA法,但高于TCT串联HPV-DNA法(均P<0.05);特异度为86.78%,高于TCT法、HPV-DNA法、TCT并联HPV-DNA法(均P<0.05);准确率为76.41%,高于HPV-DNA法、TCT并联HPV-DNA法(均P<0.05)。结论 CSRAS在宫颈癌及HSIL筛查中有较高的特异度及准确率,可以提高宫颈癌及HSIL筛查的效能。

Objective To explore the application value of the Cervical Cancer Screening Risk Assessment Scale(CSRAS)for screening cervical cancer and high-grade squamous intraepithelial lesion(HSIL)in the population undergoing health check-up.Methods The clinical and check-up data of 195 patients with abnormal results of the Thinprep cytologic test(TCT)and/or human papilloma virus(HPV)test,and undergoing cervical tissue biopsy via colposcope,were retrospectively analyzed.The Kappa consistency test was employed to analyze the consistency of TCT,HPV-DNA,TCT combined with HPV-DNA,and CSRAS(scale method)with the results of pathological examination.The efficiency of scale method for screening cervical cancer and HSIL was compared with TCT,HPV-DNA,and TCT combined with HPV-DNA.Results The scale method was basically consistent with the result of pathological examination(Kappa=0.480,P<0.05),whereas the TCT,HPV-DNA,TCT in the parallel connection with HPV-DNA,TCT in series with HPV-DNA were poorly consistent with the result of pathological examination(Kappa<0.4).The sensitivity of the scale method for screening cervical cancer and HSIL was 59.46%,which was lower than that of the TCT in the parallel connection with HPV-DNA,while was higher than that of the TCT in series with HPV-DNA(all P<0.05).The specificity was 86.78%,which was higher than that of the TCT,HPV-DNA,TCT in the parallel connection with HPV-DNA(all P<0.05);furthermore,the accuracy was 76.41%,which was higher than that of the HPV-DNA,TCT in the parallel connection with HPV-DNA(all P<0.05).Conclusion CSRAS has preferably high specificity and accuracy for screening cervical cancer and HSIL,which can improve the efficiency for screening cervical cancer and HSIL.