TCT联合高危型HPV DNA检测在不能明确意义的鳞状上皮细胞病变的诊断价值

Diagnostic value of TCT combined with high-risk HPV DNA in the diagnosis of undefined squamous cell lesions

目的探讨薄层液基细胞学检查(TCT)诊断为不能明确意义的鳞状上皮细胞病变(ASCUS)患者联合高危型人乳头瘤病毒脱氧核糖核酸(High-risk HPV DAN,HR-HPV DNA)检测的诊断价值,同时比较未绝经组与绝经组的结果,科学指导临床绝经后女性宫颈癌筛查。方法回顾性分析我院在2015年9月～2016年6月行宫颈癌筛查的患者200例,所有患者均行TCT及HR-HPV DNA检测,其中诊断为ASC-US的患者99例,未见肿瘤细胞(NILM)101例;以病理活检为金标准,对比分析TCT联合HR-HPV DNA的诊断价值,同时分析其在绝经患者宫颈癌筛查中的价值。结果 TCT检测灵敏度为71.0%,特异度为72.0%,准确率为71.5%,阳性预测值为71.7%,阴性预测值为71.3%;TCT联合HR-HPV DNA检测灵敏度为89.0%,特异度为87.0%,准确率为88.0%,阳性预测值为87.3%,阴性预测值为88.8%;联合检测的灵敏度、特异度、准确率、阳性预测值和阴性预测值均高于单项检测,差异有统计学意义(P<0.05)。绝经组与未绝经组比较,TCT联合HR-HPV DNA检测具有更高的阳性率(P<0.05)。结论 TCT联合HR-HPV DNA检测可显著提高临床宫颈癌筛查水平,尤其对于绝经后女性具有更高的诊断价值。

Objective Objective to investigate the diagnostic value of TCT-TCTdiagnosis of squamous epithelial lesions （ASC-USS） with high risk HPV DANHR-HPV DNA in patients with high-risk human papillomavirus （HPV）. At the same time, we compared the results of premenopausal women with menopausal women, and scientifically guided the screening of cervical cancer in postmenopausal women.Methods A retrospective analysis was made on 200 cases of cervical cancer screening from September 2015 to June 2016 in our hospital. All patients were examined by TCT and HR-HPV DNA. 99 cases were diagnosed as ASC-US, and 101 cases had no tumor cells. The diagnostic value of TCT combined with HR-HPV DNA and its value in screening cervical cancer in menopausal patients were analyzed.Results the sensitivity,specifcity,accuracy,positive predictive value,negative predictive value and negative predictive value of TCT were 71.0, 72.0, 71.5, 71.7and 71.7g, respectively. The sensitivity,specifcity and accuracy of TCT were 89.0,87.0 and 88.0,respectively.The positive predicti vevalue was 87.3 and the negative predictive value was 88.8.These nsitivity,specifcity,accuracy,positivepredictivevalue and negative predictive value of the combined test were higher than those of the single test. The difference was statisti call ysignifcant（P〈 0.05）. The positive rate of TCT combined with HR-HPV DNA was higher than that of unmenopausal group （P 〈 0.05）.Conclusion TCT combined with HR-HPV DNA detection can signifcantly improve the level of clinical cervical cancer screening. Especially for postmenopausal women have higher diagnostic value.