宫颈病变诊断中TCT和HPV联合检测结果分析

Thinprep cytology test combined with HPV detection in cervical lesions

目的探讨液基薄层细胞学(TCT)技术联合人乳头状瘤病毒(HPV)检测在宫颈病变诊断中的价值。方法对2150例患者进行TCT和HPV检测,其中有1项或2项检测异常者同时进行阴道镜下活体组织检查,并以病理结果为金标准,比较两种方法及其联合检测的敏感度、特异度、诊断正确率、阳性预测值、阴性预测值。结果TCT检测阳性171例,敏感度95.9%,特异度56.5%,诊断正确率83.3%,阳性预测值82.5%,阴性预测值86.7%;HPV检测阳性178例,敏感度94.6%,特异度43.5%,诊断正确率78.2%,阳性预测值78.1%,阴性预测值78.9%;TCT和HPV联合检测阳性162例,敏感度98.6%,特异度75.4%,诊断正确率91.2%,阳性预测值89.5%,阴性预测值96.3%。TCT与HPV检测结果比较差异不显著(P>0.05),TCT或HPV检测结果与两种方法联合检测结果比较差异显著(P<0.05),联合检测的特异度和诊断正确率与上述一种方法比较差异显著(P<0.05)。结论 TCT与HPV检测是筛查宫颈病变的有效方法,两种方法联合应用可提高宫颈病变的诊断正确率和特异度。

Objective To evaluate the diagnostic values of thinprep-cytological test （TCT） combined with human papilloma virus （HPV） detection in cervical lesions. Methods The 2150 patients received TCT and HPV detection, the patients with abnormal results received histopathological examination, and the pathological results were used as a gold standard. The sensitivity, specificity, diagnostic accuracy, positive prediction and negative prediction of the two methods were compared. Results 171 patients were found with positive results by TCT detection and the sensitivity, specificity, diagnostic accuracy, positive prediction and negative prediction were 95.9%, 56. 5%, 83. 3%, 82. 5% and 86.7% respectively. 178 patients were found with positive results by HPV detection, the sensitivity, specificity, diagnostic accuracy, positive prediction and negative prediction were 94. 6% , 43.5 % , 78. 2%, 78. 1% and 78.95 %, nespectively. 162 patients were found with positive results by TCT combined with HPV detection and the sensitivity, specificity, diagnostic accuracy, positive prediction and negative prediction were 98.6%, 75.4%, 91.2%, 89. 5% and 96. 3%, nespectively. No significant differences were found between the detection of TCT and HPV （ P 〉 0.05 ）. Significant differences were found between the detection of TCT or the HPV and the TCT combined with HPV （P 〈 0.05 ）. Significant differences were found between the positive rate and specificity of the detection of TCT or HPV and the TCT combined with HPV （ P 〈 0. 05 ）. Conclusion The guiding values of TCT and HPV genotyping detection are definite in screening of early cervical lesions, which can be used as an advanced screening method. Combination of the two methods may increase the positive detection rate and specificity.