LCT联合HPV检测在宫颈癌前病变诊断中的应用价值观察

Application value of LCT combined with HPV test in the diagnosis of preinvasive lesions of cervical carcinoma

目的探讨液基细胞学检查（LCT）联合人乳头瘤病毒（HPV）检测在宫颈癌前病变诊断中的应用价值。方法选取2013年1月~2015年12月在我院行宫颈癌筛查的40例妇女作为研究对象,进行LCT与HPV检查,并通过病理组织学检查进行确诊,比较LCT、HPV单独检测及联合检测的灵敏度、特异度等指标。结果 40例受检者中经病理检测确诊为阳性的有23例,其中LCT检测为阳性的有18例,HPV检测为阳性的有13例,LCT联合HPV检测为阳性的有22例,LCT、HPV联合检测的阳性检出率明显高于HPV、LCT单独检测,差异有统计学意义（χ~2=9.68,4.21,P〈0.05）。LCT联合HPV检测的灵敏度、特异度明显高于LCT、HPV单独检测,差异有统计学意义（χ~2=4.21,9.68,4.50,5.88,P〈0.05）。LCT联合HPV检测的阳性似然比与约登指数高于单独检测、阴性似然比低于单独检测。结论液基细胞学检查与人乳头瘤病毒检测在宫颈癌前病变诊断中均有一定的意义,但二者联合检测更具有诊断价值,值得临床推广应用。

Objective To explore the application value of liquid-based cytology test（LCT） combined with human papillomavirus（HPV） test in the diagnosis of preinvasive lesions of cervical carcinoma. Methods 40 women who received cervical cancer screening in our hospital from January 2013 to December 2015 were selected and received LCT and HPV test. The results were diagnosed by histopathological examinations, the sensitivities and specificities of LCT, HPV, and LCT combined with HPV test were compared. Results Among the 40 women, there were 23 cases detected positive by pathological examinations. Among the 23 patients, there were 18 cases with positive LCT results, 13 cases with positive HPV test results, and 22 cases with positive combined test results. For the LCT combined with HPV test, the positive detection rate was obviously higher than those of the LCT or HPV test, the differences were statistically significant（χ~2=9.68, 4.21, P 0.05）, the sensitivity and specificity were obviously higher than those of the LCT or HPV test, the differences were statistically significant（χ~2=4.21,9.68,4.50,5.88, P 0.05）, the positive likelihood ratio and Youden index were higher and the negative likelihood ratio were lower than those of the LCT or HPV test. Conclusion The LCT and HPV test are effective in the diagnosis of preinvasive lesions of cervical carcinoma, while the LCT combined with HPV test is more effective, which is worthy of clinical promotion.