人乳头瘤病毒DNA检测在宫颈癌前病变筛查中的应用

Use of human papillomavirus DNA assay in screening of cervical precancerous lesions

目的:探讨人乳头瘤病毒(HPV)DNA检测在宫颈癌前病变筛查中的应用价值。方法:收集2016年4月至2019年6月本院收治的宫颈癌前病变疑似患者100例,检测不同病变程度宫颈组织HPV DNA表达,并以宫颈刮片病理学检查结果为标准,计算HPV DNA检测的敏感度、特异度、阳性预测值、阴性预测值及Kappa值。结果:HPV DNA检测HPV阳性率高于宫颈刮片(P<0.05)。HPV DNA检测宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ、宫颈浸润癌的特异度分别为69.23%、83.33%、80.00%、87.50%,灵敏度分别为76.19%、75.00%、76.92%、85.71%,阳性预测值分别为80.00%、85.71%、83.33%、85.71%,阴性预测值分别为64.28%、71.43%、72.73%、87.50%,Kappa值分别为0.448、0.571、0.563、0.732。结论:HPV DNA检测在宫颈癌前病变筛查中的特异度、敏感度较好,具有较高的临床价值。

Objective:To investigate the use of human papillomavirus(HPV)DNA assay in the screening of cervical precancerous lesions.Methods:A total of 100 patients with suspected cervical precancerous lesions admitted to our hospital between April 2016 and June 2019 were included in the study.The HPV DNA expression in different cervical lesions was determined.Based on the pathological results of cervical smear,the sensitivity,specificity,positive predictive value,negative predictive value and Kappa value determined by HPV DNA assay were calculated.Results:The positive rate of HPV detected by HPV DNA assay was higher than that of cervical smear(P<0.05).The specificity of HPV DNA assay for cervical intraepithelial neoplasia(CIN),CINⅡ,CINⅢ,and invasive cervical cancer was 69.23%,83.33%,80.00%,and 87.50%,respectively;the sensitivity was76.19%,75.00%,76.92%and 85.71%,respectively;the positive predictive value was 80.00%,85.71%,83.33%and 85.71%,respectively;the negative predictive value was 64.28%,71.43%,72.73%and 87.50%,respectively;and the Kappa value was 0.448,0.571,0.563 and 0.732,respectively.Conclusion:The specificity and sensitivity of HPV DNA assay in the screening of cervical precancerous lesions are good,with high clinical value.