液基薄层细胞学联合高危型人乳头瘤病毒检测诊断宫颈癌及癌前病变的价值

Value of thin-prep cytologic test combined with high-risk human papillomavirus detection in diagnosis of cervical cancer and cervical precancerous lesions

目的探讨液基薄层细胞学(TCT)联合高危型人乳头瘤病毒(HPV)检测在宫颈癌及癌前病变诊断中的价值。方法对同一时期行TCT、高危型HPV检测的568例妇女临床资料行回顾性调查分析,所有受检者均行阴道镜活检,将其作为金标准,分析568例受检对象TCT和高危型HPV检测结果,绘制工作特征(ROC)曲线,比较曲线下面积(AUC),并探讨TCT联合高危型HPV检测在宫颈癌及癌前病变中应用价值。结果 568例受检者中79例检出宫颈病变,其中慢性宫颈炎所占比例最高,为40.51%,宫颈癌及癌前病变20例,占25.32%;54例TCT检测阳性,阳性率为9.51%,TCT阳性检测结果中ASCUS所占比例最高;高危型HPV检测结果显示568例受试者中共有56例高危型HPV阳性,阳性率为9.86%;TCT检测、高危型HPV检测和联合检测AUC分别为0.725、0.801和0.932,TCT和高危HPV检测AUC均小于联合检测,且联合检测灵敏度和准确度均明显高于TCT和高危HPV检测。结论采用TCT联合高危型HPV在宫颈癌及癌前病变筛查中应用可明显提高灵敏度和准确度,具有较高应用价值。

Objective To explore the value of thin-prep cytologic test（ TCT） combined with high-risk human papillomavirus（ HPV）detection in diagnosis of cervical cancer and cervical precancerous lesions. Methods The clinical data of five hundred and sixty-eight women detected by TCT and high-risk HPV detection during the same period were retrospectively investigated and analyzed. And all the subjects were given colposcopic biopsy,which was used as the gold standard,and the detection results of TCT and high-risk HPV detection of all the research subjects were analyzed. According to these results,receiver operating characteristic（ ROC） curve was made and the areas under ROC curve（ AUC） were compared. The application value of TCT combined with high-risk HPV detection in diagnosis of cervical cancer and cervical precancerous lesions was analyzed. Results There were seventy-nine patients with cervical lesions among the five hundred and sixty-eight subjects,among which the rate of chronic cervicitis was the highest（ 40. 51%）. There were twenty patients with cervical cancer and cervical precancerous lesions,accounting for 25. 32%. There were fifty-four patients with positive TCT test results,the positive rate was 9. 51%; and the proportion of ASCUS among the detection results was the highest. There were fifty-six patients with positive high-risk HPV detection results among the five hundred and sixty-eight patients,the positive rate was 9. 86%. The AUC values of TCT,high-risk HPV detection,and combination test of TCT and high-risk HPV detection were 0. 725,0. 801,and 0. 932,respectively; the AUC values of TCT and high-risk HPV detection were lower than that of combination test. The sensitivity and accuracy of combination test were significantly higher than those of TCT and high-risk HPV detection. Conclusion The application of TCT combined with high-risk HPV detection in screening of cervical cancer and cervical precancerous lesions can significantly increase the sensitivity and accuracy,which has high application value.