鳞状细胞癌相关抗原联合人乳头瘤病毒蛋白L1在宫颈癌诊断中的应用

Application of squamous cell carcinoma associated antigen combined with human papillomavirus protein L1 in diagnosis of cervical cancer

目的研究鳞状细胞癌相关抗原(SC-CA)联合人乳头瘤病毒蛋白L1(HPVL1)在宫颈癌诊断中的应用价值。方法选取从2013年2月～2018年2月收治的疑似宫颈癌患者96例为观察对象。采用微粒酶免疫检测技术检测所有患者血清SC-CA水平,采用免疫组织化学法检测所有患者HPVL1表达情况。以手术病理诊断为金标准,分析血清SC-CA水平、HPVL1以及两者联合诊断宫颈癌的灵敏度、特异度、阳性预测值、阴性预测值情况。此外,比较不同病理分期宫颈癌患者的血清SC-CA水平以及HPVL1阳性率。结果以病理诊断为金标准,SC-CA诊断宫颈癌的灵敏度为87.10%,特异度为79.41%,阳性预测值为88.52%,阴性预测值为77.14%。HPVL1诊断宫颈癌的灵敏度为82.26%,特异度为82.35%,阳性预测值为89.47%,阴性预测值为71.79%。SC-CA联合HPVL1诊断宫颈癌的灵敏度为98.39%,特异度为100.00%,阳性预测值为100.00%,阴性预测值为97.14%。分化程度G1～G2、FIGO分期Ⅰ～Ⅱ期患者SC-CA水平低于分化程度G3、FIGO分期Ⅲ～Ⅳ期患者(P <0.05);分化程度G1～G2、FIGO分期Ⅰ～Ⅱ期患者HPVL1阳性率高于分化程度G3、FIGO分期Ⅲ～Ⅳ期患者(P <0.05)。结论 SC-CA联合HPVL1应用于宫颈癌的诊断中可显著提高灵敏度、特异度、阳性预测值以及阴性预测值。

Objective To study the application value of squamous cell carcinoma associated antigen(SC-CA)combined with human papillomavirus protein L1(HPVL1)in the diagnosis of cervical cancer.Methods A total of 96 suspected cases of cervical cancer examined in the hospital from February 2013 to February 2018 were selected as subjects.The serum SC-CA level of all patients was detected by microenzyme immunoassay,and the expression of HPVL1 in all patients was detected by immunohistochemistry.The sensitivity,specificity,positive predictive value and negative predictive value of serum SC-CA level,HPVL1,and the combined method in cervical cancer diagnosis were analyzed based on the gold standard of surgical pathology.In addition,serum SC-CA levels and HPVL1 positive rates were compared among patients with different pathological stages of cervical cancer.Results According to the gold standard of pathological diagnosis,the sensitivity and specificity of SC-CA in diagnosing cervical cancer were 87.10%,79.41%,88.52%,and 77.14%,respectively.The sensitivity and specificity of HPVL1 in the diagnosis of cervical cancer were 82.26%,82.35%,89.47%and 71.79%respectively.The sensitivity,specificity,positive predictive value and negative predictive value of SC-CA combined with HPVL1 were 98.39%,100.00%,100.00%and 97.14%respectively.Differentiation of G1 and G2,FIGO stagingⅠ-Ⅱstage cancer SC-CA levels below the differentiation degree G3,FIGO stagingⅢ-Ⅳpatients;HPVL1 positive rate of patients with differentiation degree of G1 and G2,FIGO stageⅠ-Ⅱwas higher than that of patients with differentiated G3,FIGO stageⅢ-Ⅳ(all P<0.05).Conclusion SC-CA combined with HPVL1 can significantly improve the sensitivity,specificity,positive predictive value and negative predictive value in the diagnosis of cervical cancer.