摘要
目的探讨HPV-DNA检测结合TCT在宫颈病变筛查中的应用价值。方法分析2231例行TCT和HPV-DNA检查的患者,其中678例行道镜下活组织检查并有病理结果的临床资料。结果 1)2231例TCT中检出阳性率为15.51%,与病理结果比较,TCT中检出LSIL 29例(与病理为CINⅠ的符合率35.80%),HSIL 27例(与CINⅡ和CINⅢ的符合率90.00%),宫颈癌4例(符合率100%)。2)2231例HPV-DNA筛查中,阳性率35.45%,HPV-DNA与病理结果一致率为62.62%,其中TCT结果为ASC-US病例中,HPV-DNA阳性,病理结果阳性者占73.87%;HPV-DNA阴性,病理结果阴性者占83.58%,一致率为77.52%,均具有较高的一致率(P<0.05)。3)TCT用于评价宫颈高度病变的灵敏度、特异度、一致率、阳性预测值、阴性预测值、Kappa值、Youden值分别为:58.92%,71.69%,65.04%,69.33%,61.64%,0.3042,0.3061;HPV-DNA检测分别为:90.65%,41.23%,66.96%,62.62%,80.24%,0.3251,0.3188;TCT联合HPV分别为:96.30%,69.44%,86.53%,84.65%,91.46%,0.6932,0.6574。结论联合采用HPV-DNA及TCT检查能及早发现宫颈癌前病变,提高检出率,降低假阴性。
Objective To evaluate the instructive value of human papillomavirus(HPV-DNA) test and thinprep cytology test(TCT) in diagnosis of cervical lesions.Methods 2231 cases of HPV-DNA,TCT and 678 cases of biopsy under colposcopy were retrospectively analyzed.Results 1)2231 examined women consisted of 346 women diagnosed positive in TCT,detected rate being 15.51%;29 cases were related with LSIL(The coincidence rate 35.80%),27(90.00%)with HSIL,4 cases(100.0%)with SCC;2) The positive rate of HPV-DNA in the 2231 examined women was 35.45%;the coincidence rates of HPV-DNA with pathologic biopsy were 62.62%,(they were 77.52% when TCT were ASC-US).Both of them had the high coincidence rates(P0.05).3) The sensitivity,specificity,efficiency,positive predictive value(PPV),negative predictive value(NPV),Kappa values,Youden values of the thinprep cytological test were :58.92%,71.69%,65.04%,69.33%,61.64%,0.3042,0.3061;The group of HPV-DNA were: 90.65%,41.23%,66.96%,62.62%,80.24%,0.3251,0.3188;The group of HPV-DNA and TCT were : 96.30%,69.44%,86.53%,84.65%,91.46%,0.6932,0.6574.Conclusions HPV-DNA and TCT test play an important role in early diagnosis of CIN and cervical carcinoma.
出处
《齐齐哈尔医学院学报》
2011年第24期3948-3951,共4页
Journal of Qiqihar Medical University
基金
苏州市科学技术局社会发展科技计划项目
"太仓市卫生人才计划培养项目"资助