HPV联合TCT检测在宫颈癌筛查中的应用观察

Application of HPV detection combined with TCT in cervical cancer screening

目的探讨人乳头瘤病毒(HPV)联合薄层液基细胞学(TCT)检测在宫颈癌筛查中的应用。方法选择2018年3月-2019年3月我院收治的疑似宫颈癌患者82例作为研究对象,诊断金标准为阴道镜下宫颈组织病理检查结果,均进行HPV、TCT检测,并分析HPV、TCT单项测定与联合测定准确度、灵敏度、特异度、阳性预测值、阴性预测值。结果 82例患者经病理确诊为宫颈癌的71例;其中确诊者HPV平均值为(6.85±0.26)IU,正常者为(1.08±0.15)IU,差异具有统计学意义(t=71.537,P=0.000);HPV、TCT单项指标的阳性检出率分别为75.61%、68.29%,均低于联合检测的84.15%,差异具有统计学意义(χ^2=4.829、11.293,P=0.028、0.001);HPV、TCT单项检测曲线下面积明显小于联合检测;HPV、TCT联合检测准确度、灵敏度、特异度、阳性预测值、阴性预测值分别为90.24%、97.18%、45.45%、92.00%、71.42%,均高于各单项测定结果。结论 HPV、TCT联合检测有助于提升宫颈癌筛查的准确度,有效降低漏诊、误诊率,对早期宫颈癌诊断、临床治疗、预后评估具有重要意义。

Objective To investigate the application of human papillomavirus(HPV) detection combined with thin layer liquid-based cellular test(TCT) in cervical cancer screening.MethodsA total of 82 patients with suspected cervical cancer treated in a hospital from March 2018 to March 2019 were selected as the research objects. The diagnostic gold standard was the results of cervical pathological examination under colposcopy. HPV detection and TCT were performed, and the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of HPV detection and TCT were investigated and analyzed.Results Among the 82 suspected patients, 71 cases were definitely diagnosed as cervical cancer, and among the definitely diagnosed cervical cancer patients, the average HPV value was(6.85±0.26) IU, but the value of the normal people was(6.85±0.26) IU(t = 71.537, P = 0.000). The positive rate of HPV single index was 75.61%and the positive rate of TCT was 68.29%, which was significantly lower than that of the joint tests(84.15%, χ^2= 4.829,11.293, P = 0.028, 0.001). The area under the curve(AUC) of HPV detection or AUC of TCT was significantly less than that of the joint tests. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 90.24%,97.18%, 45.45%, 92.00% and 71.42%, respectively, which were higher than those of each single test.Conclusion HPV and TCT combined detection is helpful to improve the accuracy of cervical cancer screening, effectively reduce the missed diagnosis and misdiagnosis rate, and is of great significance for the diagnosis, clinical treatment and prognosis evaluation of early cervical cancer.