宫颈癌筛查中高危型HPV及液基细胞学联合应用的临床价值

Clinical Value of High-risk HPV and Liquid Based Cytology in the Screening of Cervical cancer

目的探究在宫颈癌筛查中使用高危型人乳头瘤病毒HPV检测联合液基细胞学检测在临床上的诊断价值。方法对该院2015年2月—2016年5月该院妇科收治的200例育龄妇女进行高危型HPV检测、阴道镜下病理学活检和液基细胞学检查,"金标准"为阴道镜下病理学活检的结果,评价高危型HPV检测联合液基细胞学检测对诊断宫颈癌和癌前病变筛查效果。结果在200例育龄妇女中,高危型HPV检测方法得到的阳性检出率为53.5%,液基细胞学检测方法的检出率(不典型性鳞状细胞ASC以上病变)为42.5%。联合两种检测方法对宫颈上皮内瘤变(CIN)I以上的病变筛查效果(χ~2=9.67)其灵敏度(92.5%)、阴性预测值(90.5%)、阳性预测值(89.9%)、符合率(90.3%)、约登指数(0.78)都较单独检测方法(HPVχ~2=38.71液基细胞学检验χ~2=34.45)检验优越。结论联合高危型HPV检测和液基细胞学检测方法对于宫颈癌筛查结果更为准确,有重要的临床诊断意义。

Objective To study the clinical value of high-risk HPV and liquid based cytology in the screening of cervical cancer. Methods 200 cases of women at the childbearing age admitted and treated in our hospital from February2015 to May 2016 were selected for high-risk HPV, colposcopic pathological biopsy and liquid based cytology, and the results of colposcopic pathological biopsy were the golden standards, and the screening effects of high-risk HPV and colposcopic pathological biopsy in diagnosis of cervical cancer and precancerous lesions were evaluated. Results Of200 cases of women at the childbearing age, the positive test rate of high-risk HPV was 53.5% and the test rate（ atypical squamous cell above ASC lesions） of the liquid based cytology was 42.5%, and the screening effect, sensitivity,negative predictive value, positive predicative value, coincidence rate, and Youden index of the two methods in diagnosis of（CIN） lesions above I were χ~2=9.67, 92.5%, 90.5%, 89.9%, 90.3%, 0.78, which were better than those of the single test methods,（HPV χ~2=38.71, liquid based cytology test χ~2=34.45）. Conclusion The results of high-risk HPV and liquid based cytology in the screening of cervical cancer are more accurate, with important clinical diagnosis significance.