HPV感染者血清鳞状上皮癌抗原检测的临床意义

The clinical significance of detection of squamous cell carcinoma antigen in HPV infected person

目的 探讨HPV-DNA检测和SCC-Ag检测在宫颈癌筛查中的应用价值,探求更准确的宫颈癌初筛指标.方法 选择经病理确诊的517例CIN患者,63例宫颈癌患者以及20例健康对照者进行宫颈分泌物HPV-DNA检测和血清SCC-Ag（鳞状上皮癌抗原）检测,并对实验结果进行单个指标和联合检测分析.结果 以SCC-Ag≥1.5 ng/ml为阳性,CIN组阳性率为4.45％,宫颈癌组阳性率为66.67％,差异有统计学意义;CIN组HPV-DNA检测阳性率为4.26％,宫颈癌组HPV-DNA阳性率为96.83％,差异有统计学意义.HPV-DNA诊断宫颈癌的敏感度为96.83％,特异度为95.90％,检测准确性为96.00％; SCC-Ag诊断宫颈癌的敏感度为66.67％,特异度为95.72％,检测准确性为92.67％;联合检测检出阳性58例,诊断宫颈癌的敏感度为87.30％,特异度为99.44％,准确性为98.17％.结论 HPV-DAN阳性者联合SCC-Ag检测可提高诊断的准确性,HPV-DNA检测和SCC-Ag检测联合应用对宫颈癌的诊断具有重要的临床意义.

Objective To study the application value of squamous cell carcinoma antigen(SCCAg) and HPV genotyping detection in diagnosis of cervical cancer.Method SCC-Ag and HPV were detected in 517 cases of CIN,63 cases of cervical cancer and 20 cases of healthy people.Results It took SCCAg ≥ 1.5 ng/ml as the cut-off.The positive rate in CIN group was 4.45％,while that in cervical cancer group was 66.67％.The positive rate of HPV-DNA in CIN group was 4.26％,while that in cervical cancer group was 96.83％.The sensitivity,specificity and accuracy rate of HPV-DNA were 96.83％,95.90％ and 96.00％; those of SCC-Ag were 66.67％,95.72％ and 92.67％; those of joint detection were 87.30％,99.44％ and 98.17％.Conclusions SCC-Ag can improve the accuracy rate of cervical cancer in HPV-DNA positive cases.The combination of SCC-Ag and HPV-DNA has important clinical significance in diagnosis of cervical cancer.