高危型人乳头状瘤病毒和宫颈细胞学联合检测在诊断宫颈病变中的临床价值

Clinic value of combination of high-risk human papillomavirus test and cervical cytology test in diagnosing cervical lesions

目的探讨高危型人乳头状瘤病毒（high-risk human papillomavirus，HR-HPV）和宫颈细胞学联合检测在诊断宫颈病变中的临床价值。方法对2004年10月至2006年12月北京大学第一医院就诊的患者进行HR-HPV检测和宫颈细胞学检查，对一项或两项结果异常者均行阴道镜下宫颈活检，并以宫颈活检结果为金标准，比较HR-HPV检测、宫颈细胞学检查、HR-HPV和宫颈细胞学联合检测对宫颈病变的诊断价值。结果HR-HPV检测、宫颈细胞学检查及HR-HPV检测联合宫颈细胞学检查对诊断宫颈病变有不同价值。HR-HPV检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为94．83％、31．06％、55．22％、87．02％，宫颈细胞学筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为92．10％、31．06％、54．50％、81．43％，HR-HPV和宫颈细胞学联合检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为99．65％、18．55％、61．46％、97．62％。结论采用HR-HPV和宫颈细胞学联合检测可提高宫颈病变的检出率，并可指导临床医生对宫颈病变的治疗。

Objective To investigate the clinic value of combination of high-risk human papillomavirus test and cervical cytology test in diagnosis of cervical lesions. Methods Patients underwent physical examination at our department were checked by high-risk human papillonmvirus test, cervical cytology test and colposcope from October 2004 to December 2006. Abnormal patients with cervical abnormalities were asked for pathological test. The diagnostic value of cervical lesions among these different methods were compared. Results Based on the criteria of histopathology, the sensitivity, specificity, positive-predictive value and negative-predictive value of high-risk human papillomavirus test for detecting all cases of CINⅡ and CIN Ⅲ were 94.83 %, 31.06 %, 55.22 % and 87.02 % respectively,and those of the cervical cytology were 92.10% ,31.06% ,54.50% and 81.43% respectively.Those values changed to 99.65%, 18.55%, 61.46% and 97.62% respectively if two methods were combined. Conclusions Human papillomavirus test and cervical cytology test combined with pathological test can improve the detective rate of cervical lesions and facilitate the treatment.