液基细胞学结合HPV高危分型检测对宫颈病变应用价值的评估

Evaluation on the application value of Liquid-based cytology combined with high-risk HPV genotyping in cervical lesions

目的评估宫颈液基细胞学结合高危性HPV DNA检测在宫颈病变中的诊断价值。方法收集本院2009-2012年细胞室及HPV检测室的资料进行评估分析。结果液基细胞学阳性检出率6.01%,HPVDNA高危型分型检出率20.34%,两种方法联合检测的评估指标:阳性检测率33%,敏感性、特异性、阳性预测值、阴性预测值88.58%。结论单独应用上述两种筛查方法都有一定的局限性,但有较高敏感性,阴性预测值及阳性检出率。联合应用检测后不但能够优势互补,而且其敏感性、阴性预测值、阳性检出率更高,但其特异性反而降低。具体原因不详,有待于在今后工作中进一步深入探讨。对已婚妇女在进行细胞学及HPV检测的同时,对HPV检测阳性病例如能采用HPV疫苗治疗,对于HPV检测阴性病例如能早期接种HPV疫苗预防,对于宫颈癌的防治效果会更加科学与完善。

Objective To evaluate the diagnostic value of liquid-based cytologic test combined with high-risk HPV DNA de-tection in the diagnosis of cervical lesions. Methods The data of HPV and liquid-based cytologic test derived from the cell apart-ment and HPV test room in Xiaolan hospital from 2009 to 2012 were collected, evaluated and analyzed. Results The positive de-tection rate of liquid-based cytologic test was 6.01%. The positive rate of high-risk HPV DNA detection was 20.34%. The perfor-mance of the combination method was as follows： the positive detection rate was 33%; the sensitivity was 96.43%; the specificity was 12.62%;the positive predictive rate was 33.49%;the negative predictive rate was 88.58%. Conclusions There exist some cer-tain limitations when using LCT or HPV DNA test along. The two methods shoud be used together. The combination method had a higher sensitivity, negative predictive rate and positive detection rate, but the specificity was lower than that of each single method. HPV vaccine should be used rationally for early prevention of cervical carcinoma.