高危型人乳头瘤病毒联合液基薄层细胞学检测在宫颈早期癌变中的诊断价值及其一致性

Combined tests of high-risk human papillomavirus and ThinPrep cytology in the diagnosis of early stage cervical cancer and the consistency

目的探讨高危型人乳头瘤病毒(HPV)联合液基薄层细胞学技术(TCT)对宫颈早期癌变的诊断价值及其与病理结果的一致性。方法选取接受宫颈病理活检的患者260例,均进行高危HPV联合TCT检测,分析其与病理活检结果的一致性。结果以病理活检诊断结果为金标准,HPV联合TCT检测的阳性预测值及特异性均高于单独检测方法,单独检测与联合检测方法的特异性、灵敏度及阳性预测值对比,差异均有统计学意义(P﹤0.05);HPV联合TCT检测结果与病理活检结果符合率最高(78.46%),Kappa值=0.52,一致性最高,差异有统计学意义(P﹤0.05);2年随访中,病理活检诊断复发或残留10例,HPV联合TCT对残留或复发检测的特异性为93.33%,灵敏度为60.00%,阳性预测值为54.45%,阴性预测值为94.59%。结论 HPV联合TCT应用于宫颈早期癌变的诊断,检测结果与病理活检结果具有高度一致性,且对宫颈病变术后残留及复发具有较高的诊断价值,值得推广应用。

Objective To discuss the diagnostic value of combined tests of high-risk human papillomavirus （HPV） and ThinPrep Technology （TCT） in the early diagnosis of cervical cancer, and evaluate the consistency with pathological diagnosis. Method 260 cases who were administered with cervical biopsy were enrolled in the study, and all patients were given combined tests of high-risk HPV and TCT, and then the results were analyzed for consistency in comparison with pathological biopsy results. Result Taken pathologic biopsy as the gold standard, the combined test had significant-ly higher positive predictive value than that of either single test, while the specificity, sensitivity and positive predictive value of combined and single tests were of statistically significant difference （P〈0.05）;The combined test results had the highest consistency rate with pathological biopsy results at 78.46%, Kappa value=0.52, with significant difference ob-served （P〈0.05）;In the 2-year follow-up, pathological biopsy confirmed 10 cases of recurrent or remnant tumors, while the HPV＋TCT test had the specificity of 93.33%, the sensitivity of 60.00%, the positive predictive value of 54.45%, and the negative predictive value of 94.59%in detecting recurrent or remnant tumors. Conclusion HPV combined with TCT showed high consistency with pathological biopsy in the diagnosis of early cervical cancer, and is specific yet sensitive in detecting postoperative recurrent and remnant tumors, which is clinically applicable.