高危型HPV-DNA检测联合阴道镜在宫颈病变筛查中的临床应用价值分析

Clinical Application Value of High Risk HPV-DNA Test Combined with Colposcopy in Screening Cervical Lesions

目的:评价高危型HPV-DNA检测联合阴道镜在宫颈病变筛查中的临床应用价值。方法:选取2015年9月-2016年9月在本院妇科门诊宫颈病变筛查的已婚妇女130例,均予以高危型HPV-DNA与阴道镜检查,任一项结果异常或临床高度怀疑宫颈病变者,同时行阴道镜下宫颈多点活检组织病理诊断,以病理学结果为金标准,分析高危型HPV-DNA联合阴道镜检测对宫颈病变的诊断价值。结果:130例受检女性中,病理诊断阴性110例(84.62%),阳性20例(15.38%),其中CINⅠ11例(8.46%),CINⅡ4例(3.08%),CINⅢ3例(2.31%),宫颈癌2例(1.54%)。HR-HPV-DNA检测的灵敏度和特异度均为80.00%;阴道镜的诊断灵敏度为65.00%,特异度为64.55%;联合检查的灵敏度为90.00%,特异度为83.64%。联合检查的灵敏度、特异度均明显高于阴道镜检查,差异均有统计学意义(P<0.05);联合检查的灵敏度高于HR-HPV-DNA检测,差异有统计学意义(P<0.05);HR-HPV-DNA检测的特异度明显高于阴道镜,差异有统计学意义(P<0.05)。结论:HR-HPV-DNA检测具有较高的灵敏度和特异度,而联合阴道镜可提高诊断准确率,减少漏诊,可作为宫颈病变筛查的主要方法。

Objective： To evaluate the clinical value of high risk HPV-DNA test combined with colposcopy in screening cervical lesions.Method： 130 married women in the screening of cervical lesions from September 2015 to September 2016 were treated with high-risk HPV-DNA and colposcopy, any abnormal results or clinically suspected cervical lesions, and colposeopic cervical biopsy pathological diagnosis with pathological results as the gold standard, analysis of the value of high risk HPV-DNA combined colposcopy in diagnosis of cervical lesions. Result：Among 130 women, the pathological diagnosis of 110 cases （ 84.62% ）were negative, 20 cases （ 15.38% ） were positive, including 11 cases （ 8.46% ） of CINI, 4 cases （ 3.08% ） of CINII, 3 cases （ 2.31% ） of CINIII, 2 cases （ 1.54% ） of cervical cancer.The sensitivity and specificity of HR-HPV-DNA detection were 80.00%, the diagnostic sensitivity of eolposcopy was 65.00%, the specificity of colposeopy was 64.55% ; the colposcopy and combined examination of the sensitivity was 90.00%, the specificity was 83.64%.The sensitivity and specificity of combined examination were significantly higher than those of colposcopy, the differences were statistically significant （ P〈0.05 ） ; the sensitivity of combined detection was higher than that of HR-HPV-DNA, and the difference was statistically significant （ P〈0.05 ） ; the specificity of HR-HPV-DNA detection was significantly higher than that of colposcopy, and the difference was statistically significant （ P〈0.05 ） .Conclusion： HR-HPV- DNA has high sensitivity and specificity, and combined with colposcopy can improve the accuracy of diagnosis, reduce missed diagnosis, can be used as the main method of screening cervical lesions.