液基细胞学检查与高危型人乳头瘤病毒DNA检测在宫颈癌患者筛查中的临床价值

The Clinical Value of Liquid-based Cytology and High-risk Human Papillomavirus DNA Detection in Cervical Cancer Screening

目的探讨基液细胞学检测(TCT)与高危型人乳头瘤病毒DNA检测(HPV-DNA)在宫颈癌患者筛查中的临床价值。方法选取2020年1月-2021年9月江西中医药大学附属医院收治的宫颈癌患者120例为研究对象,以病理活检作为诊断金标准,评估TCT、HPV-DNA检测的灵敏度、特异度及诊断符合率。结果120例宫颈标本病理学检查中炎症52例、CINⅠ级23例、CINⅡ级25例、CINⅢ级12例、宫颈癌8例,病理学结果阳性68例,阳性率为56.67%;TCT、HPV-DNA检测CINⅠ级、CINⅡ级、CINⅢ级及宫颈癌患者的阳性率高于炎症患者(P<0.05);TBS分类级别越高,HPV-DNA的阳性率越高(P<0.05);TCT联合HPV-DNA检测的灵敏度、特异度及诊断符合率均高于二者单独检测(P<0.05)。结论TCT和HPV-DNA的联合使用可弥补单一检测方法的不足,提高对宫颈癌或CIN诊断的灵敏度、准确度,可有效提高宫颈癌或CIN的诊断效能和筛选价值。

Objective To explore the clinical value of thinprep cytologic test(TCT)and high-risk human papillomavirus DNA(HPV-DNA)in cervical cancer screening.Methods A total of 120 patients with cervical cancer admitted to the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2020 to September 2021 were selected as subjects.Pathological biopsy was used as the diagnostic gold standard to evaluate the sensitivity,specificity and diagnostic coincidence rate of TCT and HPV-DNA detection.Results Among the 120 cases of cervical specimens,there were 52 cases of inflammation,23 cases of CINⅠ,25 cases of CINⅡ,12 cases of CINⅢand 8 cases of cervical cancer.The pathological results were positive in 68 cases,with a positive rate of 56.67%.The positive rates of TCT and HPV-DNA in patients with CINⅠ,CINⅡ,CINⅢand cervical cancer were higher than those in patients with inflammation(P<0.05).The higher the TBS classification,the higher the positive rate of HPV-DNA(P<0.05).The sensitivity,specificity and diagnostic coincidence rate of TCT combined with HPV-DNA detection were higher than those of the two alone(P<0.05).Conclusion The combined use of TCT and HPV-DNA can make up for the deficiency of single detection method,improve the sensitivity and accuracy of diagnosis of cervical cancer or CIN,and effectively improve the diagnostic efficiency and screening value of cervical cancer or CIN.