HPV mRNA联合液基细胞学检查对中年宫颈癌前病变筛查结果分析

Application of HPV mRNA combined with liquid-based cytology in the screening of precancerous lesions of uterine cervix in middle-aged people

目的分析人乳头状瘤病毒(HPV)联合液基细胞学检查对中年宫颈癌前病变的筛查结果。方法收集2013年2月至2016年5月该院宫颈液基细胞学检查标本1 982例、宫颈HPV mRNA检测标本328例及宫颈组织学检查相关标本232例,从中筛选出同时行以上3种检查的标本126例。分析HPV mRNA联合液基细胞学检查对中年宫颈癌前病变的诊断结果。结果 126例标本中利用HPV mRNA和液基细胞学检查结果一致为92例,占73.02%。92例标本中两种检查方法均阳性45例,均阴性47例,不一致34例,其中HPV mRNA检测阳性而液基细胞学检测结果阴性24例,占70.59%,HPV mRNA检测阴性而液基细胞学检测结果阳性10例,占29.41%。HPV mRNA检测的阳性率高于液基细胞学检测,差异有统计学意义(χ2=75.235,P<0.05);HPV mRNA阳性诊断宫颈高级别鳞状上皮内瘤变(HSIL)的敏感性为69.23%,特异性为64.37%;液基细胞学诊断的敏感性和特异性分别为53.85%和85.06%。两种检查方法的敏感性和特异性比较,差异均有统计学意义(P<0.05)。结论 HPV mRNA联合液基细胞学筛查宫颈癌前病变的特异性和敏感性相对较高,在一定程度上可达到互补作用,同时还具有操作简单、无创伤性及相对经济性等特点,值得在中年宫颈癌前病变筛查中推广应用。

Objective To investigate the application of human papillomavirus(HPV)combined with liquid-basedcytology in the screening of cervical precancerous lesions in middle-aged people. Methods From February 2013 to May 2016,1 982 specimens with cervical liquid-based cytology,328 specimens with cervical HPV mRNA detection and 232 specimenswith cervical histological examination,in the hospital were collected. 126 specimen with 3 above detections were screened.The results of HPV mRNA combined with liquid-based cytology for cervical precancerous lesions in middle-aged people wereanalyzed. Results Among the 126 specimens,the detection results of HPV mRNA and liquid-based cytology in 92 cases werein accordance,accounting for 73.02%. Among the 92 specimens,the results of two methods were both positive in 45 cases,and negative in 47 cases. Among the 34 specimens without identical results of HPV mRNA and liquid-based cytology,24 cases were with positive results of HPV mRNA and negative results of liquid-based cytology,accounting for 70.59%;10 caseswere with negative results of HPV mRNA and positive results of liquid-based cytology,accounting for 29.41%. The positive rateof HPV mRNA was higher than that of liquid-based cytology,and the difference had statistical significance(χ~2=75.235,P<0.05). The sensitivity and specificity of HPV mRNA to cervical high squamous intraepithelial lesion(HSIL)were 69.23% and64.37%,respectively,while the sensitivity and specificity of liquid-based cytology to cervical HSIL were 53.85% and 85.06%,respectively. There were statistically significant difference on the specificity and sensitivity between HPV mRNA and liquid-based cytology(P<0.05). Conclusion HPV mRNA combined with liquid-based cytology has high sensitivity and specificity in the screening of cervical precancerous lesions,with complementary effect to some extent,meanwhile the combination is easy to operate,non-invasive and relatively economical,so,it is worthy of popularization and application in the screening of cervical precancerous lesions in middle-aged people.