细胞游离亚铁原卟啉检测与高危型人乳头瘤病毒检测对宫颈癌及癌前病变的筛查价值比较

Intracellular free heme concentration detection versus high-risk human papillomavirus detection in screening cervical cancer and precancerous lesions

目的:比较子宫上皮细胞稳定性细胞游离亚铁原卟啉(FH)检测与高危型人乳头瘤病毒(HPV)检测对宫颈癌及癌前病变的筛查价值。方法:选取2017年10月至2019年10月在淮南市第一人民医院诊治的宫颈异常患者238例进行FH检测及高危型HPV检测,并以液基薄层细胞学(TCT)检测及病理活检结果为金标准,比较FH检测与高危型HPV检测的诊断价值。结果:238例受检者中,TCT检测确诊正常或炎症(NLM)97例,非典型鳞状上皮细胞(ASCUS)以上级别者141例;对ASCUS以上级别者进行病理活检确诊宫颈上皮内瘤变(CIN)Ⅱ级以上病变70例;CINⅡ级以上患者FH检测阳性率为92.86%(65/70),高危型HPV检测阳性率为95.71%(67/70);FH检测对CINⅡ级以上病变筛查敏感性、特异性分别为82.86%(58/70)、85.92%(60/70),高危型HPV检测筛查敏感性、特异性分别为94.29%(66/70)、98.59%(69/70),两种方法筛查敏感性、特异性比较差异均有统计学意义(χ^(2)=4.52、10.25,均P<0.05)。结论:高危型HPV检测对宫颈癌及癌前病变的诊断有较高的应用价值,其对宫颈癌及癌前病变筛查的敏感度、特异度均高于FH检测,但FH检测操作简便、经济、快捷,更适合于宫颈癌及癌前病变的大范围筛查。

Objective To compare the application value of intracellular free heme concentration(FH)detection and high-risk human papillomavirus(HPV)detection in screening cervical cancer and precancerous lesions.Methods A total of 238 patients with cervical abnormalities who received FH and HPV detection in Huainan First People's Hospital,China from October 2017 to October 2019 were included in this study.Taking liquid-based ThinPrep cytologic test(TCT)results and pathological biopsy results as gold standard,the diagnostic value of FH detection and TCT detection for cervical cancer and precancerous lesions were compared.Results TCT results revealed normal/inflammatory diagnosis in 97 patients,and atypical squamous cells of undetermined significance(ASCUS)or higher grade diagnosis in 141 patients.Pathological biopsy results reported cervical intraepithelial neoplasia(CIN)grade II or above in 70 out of the 141 patients.The detection rate of FH detection for CIN grade II or above cervical lesions was 92.86%(65/70)and the detection rate of high-risk HPV detection was 95.71%(67/70).The sensitivity and specificity of FH detection in the screening CIN grade II or above cervical lesions were 82.86%(58/70)and 85.92%(60/70),respectively and they were 94.29%(66/70)and 98.59%(69/70)for high-risk HPV detection.There were significant differences in diagnostic sensitivity and specificity between FH dection and high-risk HPV detection(χ^(2)=4.52,10.25,both P<0.05).Conclusion High-risk HPV detection is of high application value in the diagnosis of cervical cancer and precancerous lesions.It has higher sensitivty and specificity in screening cervical cancer and precancerous lesions than FH detection.But FH detection is simpler,more economical and easier to use and is more suitable for large-scale screening of cervical cancer and precancerous lesions than high-risk HPV detection.