PCR-反向点杂交法在宫颈癌前病变筛查中的应用价值

PCR-RDB in the screening of Cervical Precancerous Lesions

目的:评价PCR-反向点杂交法(PCR-RDB)在宫颈癌前病变筛查中的应用价值。方法:2010年9月至12月,收集于医院妇科门诊就诊的424例妇女宫颈样本,行宫颈液基细胞学检查(TCT)及PCR-反向点杂交法检测高危型人乳头瘤病毒(HR-HPV DNA),TCT≥ASCUS的患者行阴道镜宫颈组织活检及必要时宫颈管诊刮,以组织病理学为金标准。病理诊断≥CIN2者为阳性组,病理诊断<CIN2为阴性组。结果:HPV阳性率为27.6%(117/424;95%CI:23.29%～31.91%),TCT≥ASCUS的112例患者中,HPV阳性病理确诊≥CIN2者51例。PCR-反向点杂交法检出≥CIN2者的灵敏度和特异度分别为82.26%(95%CI:72.75%～91.77%)和81.77%(95%CI:77.79%～85.75%),Youden指数为0.644(95%CI:0.541～0.747);PCR-反向点杂交法检出≥CIN2的ROC曲线下面积为:Z=0.906(95%CI:0.878～0.935,P<0.0001)。结论:PCR-反向点杂交法在宫颈癌前病变的筛查中具有重要的临床应用价值。

Objective：To evaluate PCR-RDB in screening of cervical precancerous lesions. Methods ：424 women＇s cervical screen samples were collected from September to December,2010. The samples were analyzed by liquid-based cytology （TCT）, High-Risk HPV PCR-RDB Test . The women with TCT≥ASCUS were examined by colposcopy and taken cervical biopsy or with endocervical curettage when necessary. The results of histopathology ≥ CIN2 was regards as positive group, 〈 CIN2 as negative group. Rusults：The positive of PCR-RDB HPV-DNA was 27.6% （ 117/424 ）. 51 of 112 TCT ~〉 ASCUS women were PCR-RDB HPV-DNA positive, and were diagonsed as t〉 CIN2 by histopmhology. The sensitivity and specificity of PCR-RDB that can detect I〉 CIN2 were 82.26% （95% CI：72.75% - 91.77% ） and 81.77% （95% CI：77.79% - 85.75 % ）, respectively. Youde-n＇s index was 0. 644 （95% CI：0.541 - 0.747 ）, the area under the ROC curve was Z =0. 906（95% CI：0.878 -0.935 ,P 〈0.0001 ）. Conclusions：PCR-RDB is a useful tool in clinical screen- ing of cervical precancerous lesions.