HPV-DNA联合肿瘤标志物检测合并阴道镜检查对宫颈癌的诊断价值

The Signification of HPV-DNA,Tumor Markers Combied with Colposcopy in the Diagnosis of Cervical Cancer

目的探讨HPV-DNA联合肿瘤标志物检测合并阴道镜检查在宫颈癌诊断中的意义。方法以180例疑似宫颈癌患者为研究对象。所有患者均行肿瘤标志物、HPV-DNA基因分型检查、阴道镜检查及病理学检查。联合检查以其中一种达到阳性标准则判定为阳性。以病理检查为金标准,对比肿瘤标志物及HPV-DNA检测联合阴道镜检查与各单项检查及两两联合方法对宫颈癌前病变(CIN)和宫颈癌的阳性结果及其灵敏度、特异度及准确度。结果对于CIN,联合检查的阳性率均略高于各单项检查,肿瘤标志物、HPV-DNA和阴道镜联合检查的阳性率均高于各单项检查和两两联合检查,且与肿瘤标志物的阳性率差异具有统计学意义(P<0.05);对于宫颈癌,各种方法的阳性率未见差异(P>0.05);肿瘤标志物、HPV-DNA和阴道镜联合检查的总阳性率高于各单项检查和两两联合检查,且与各单项检查、肿瘤标志物联合HPV-DNA检查和肿瘤标志物联合阴道镜检查的差异具有统计学意义(P<0.05);肿瘤标志物检测、HPVDNA检测和阴道镜检查联合的灵敏度、特异度和准确度高于各单项检查和两两联合检查(P<0.05)。结论肿瘤标志物检测、HPV-DNA检测和阴道镜检查联合检查可提高对宫颈癌前病变的准确度,但需要扩大样本量做进一步研究以探讨其对宫颈癌的筛查优势。

Objective To discuss the significance of HPV-DNA,tumor markers combined with colposcopy in the diagnosis of cervical cancer. Methods A total of 180 suspected cervical cancer patients were studied. All patients were given tumor markers,HPV-DNA genotyping,colposcopyand pathology examination. Pathology examination was as the gold standard. The positive results for CIN and cervical cancer and sensitivity,specificity and accuracy for cervical cancer disease by HPV-DNA,tumor markers combined with colposcopy and single inspection or 2 joint methods were compared. Results For CIN,positive rate of joint examinationwas slightly higher than single examination. Positive rate of HPV-DNA,tumor markers combined with colposcopy was higher than single examination and 2 joint inspection examination. And the difference in positive rate between HPV-DNA,tumor markers combined with colposcopy and tumor markers single examination was statistically different（ P 〈 0. 05）; For cervical cancer,there was no difference in the positive rate of various methods（ P 〉 0. 05）; Total positive rate of HPV-DNA,tumor markers combined with colposcopy was higher thansingle examination and two joint examination,and the difference between HPVDNA,tumor markers combied with colposcopy and single examination,tumor markers combined with HPV-DNA,tumor markers combined with colposcopy was statistically significant（ P 〈 0. 05）; The sensitivity,specificity and accuracy of HPV-DNA,tumor markers combied with colposcopy were higher than single examination and 2 joint examination（ P 〈 0. 05）. Conclusion HPVDNA,tumor markers combined with colposcopy can improve the accuracy of cervical cancer lesion,but need to increase sample size to do further research to explore the advantage of cervical cancer screening.