HPV联合TCT检测对宫颈病变诊断的预测价值研究

Study on the predictive value of HPV test combined with TCT detection for cervical lesions

目的探讨人乳头瘤病毒(HPV)联合液基细胞学(TCT)检测对宫颈病变诊断的预测价值,为临床诊治工作提供参考信息。方法选择2016年1月-2019年1月浙江省荣军医院收治的宫颈病变患者75例作为研究对象,均有完整的HPV检测及TCT检测资料,分别将HPV检测、TCT检测以及HPV+TCT检测结果与病理结果进行对照分析并比较诊断准确性。结果以病理结果作为金标准,HPV检测对宫颈上皮内瘤变(CIN)1、CIN2、CIN3、鳞癌患者的诊断阳性符合率为81.3%(61/75),TCT检测对CIN1、CIN2、CIN3、鳞癌患者的诊断阳性符合率为86.7%(65/75),HPV+TCT检测对CIN1、CIN2、CIN3、鳞癌患者的诊断阳性符合率为97.3%(73/75),HPV+TCT检测诊断准确性显著高于HPV检测、TCT检测,差异均有统计学意义(P<0.05)。结论HPV检测、TCT检测对女性宫颈疾病均具有一定的诊断预测价值,HPV联合TCT检测能够显著提高诊断准确性,避免漏诊、误诊的发生,临床预测价值更高,可以作为宫颈病变更为可靠的筛查方法。

Objective To explore the predictive value of human papillomavirus(HPV)test combined with Thinprep cytology test(TCT)detection for cervical lesions,provide a reference information for clinical diagnosis and treatment.Methods From January 2016 to January 2019,75 patients with cervical lesions treated in Zhejiang Province Disabled Soldier Hospital were selected,HPV test and TCT detection data were complete,the results of HPV test,TCT detection,and HPV test+TCT detection were compared with pathological results,respectively,the accuracies of diagnosis of different methods were compared.Results Taking pathological result as the gold standard,the positive coincidence rate of diagnosis of HPV test for cervical intraepithelial neoplasia(CIN)1,CIN2,CIN3,and cervical squamous cell carcinoma was 81.3%(61/75),the positive coincidence rate of diagnosis of TCT detection for CIN1,CIN2,CIN3,and cervical squamous cell carcinoma was 86.7%(65/75),the positive coincidence rate of diagnosis of HPV test+TCT detection for CIN1,CIN2,CIN3,and cervical squamous cell carcinoma was 97.3%(73/75),the accuracy of diagnosis of HPV test+TCT detection was statistically significantly higher than those of HPV test,TCT detection(P<0.05).Conclusion HPV test and TCT detection have predictive value for cervical lesions,HPV test combined with TCT detection can significantly improve diagnostic accuracy,avoid missed diagnosis and misdiagnosis,the predictive value is high,which can be used as a reliable screening method for cervical lesions.