宫颈特殊染色法联合人乳头状瘤病毒E6/E7 mRNA与液基薄层细胞学检查在宫颈癌筛查中的诊断价值

Diagnostic value of cervical special staining combined with human papillomavirus E6/E7 mRNA and thinprep cytologic test in cervical lesions screening

目的探究宫颈特殊染色法(FRD)联合高危型人乳头状瘤病毒(HPV)E6/E7 mRNA与液基薄层细胞学(TCT)在宫颈癌筛查中的诊断价值。方法选取2018年10月至2019年11月在萧山医院行宫颈癌筛查的734例疑似宫颈癌患者作为研究对象,进行FRD、HPV E6/E7 mRNA和TCT检测。以阴道镜取样活组织检查作为金标准,对比以上检测手段单独检测及联合检测对宫颈癌的诊断效能。结果734例疑似宫颈癌患者中,病理活组织检查阳性率为9.81%(72例);FRD阳性率为11.99%(88例),HPV E6/E7 mRNA阳性率为12.53%(92例),TCT阳性率为14.44%(106例),符合率分别为93.46%、92.37%和89.92%,FRD、HPV E6/E7 mRNA与病理学诊断结果的Kappa值分别为0.664和0.616,TCT与病理学诊断结果的Kappa值为0.529。FRD、HPV E6/E7 mRNA和TCT的灵敏度分别为77.78%、75.00%和72.22%,且3种方法联合检查的灵敏度为95.83%,优于单独检查。结论FRD在宫颈癌筛查方面具有与TCT、HPVE6/E7 mRNA相仿的效能,且与TCT、HPV E6/E7 mRNA联合应用有助于提高灵敏度,加之具有快捷和成本低的特点,有一定的推广意义。

Objective To explore the diagnostic value of cervical special staining(FRD)combined with high-risk HPV E6/E7 mRNA and thinprep cytologic test(TCT)in cervical lesions screening.Methods A total of 734 women who underwent cervical lesions screening in Xiaoshan Hospital from October 2018 to November 2019 were enrolled for FRD,HPV E6/E7 mRNA and TCT detection.Colposcopy sampling and biopsy was taken as the gold standard.The diagnostic efficacy of the above detection methods and combined detection in cervical lesions was compared.Results In 734 patients with suspected cervical lesions,the positive rates of pathological biopsy,FRD,HPV E6/E7 mRNA and TCT were 9.81%(72 cases),11.99%(88 cases),12.53%(92 cases)and 14.44%(106 cases),respectively.The coincidence rates were 93.46%,92.37%and 89.92%,respectively.The Kappa coefficients between FRD,HPV E6/E7 mRNA and pathological diagnosis were 0.664 and 0.616,respectively.The Kappa coefficient between TCT and pathological diagnosis was 0.529.The sensitivities of FRD,HPV E6/E7 mRNA and TCT were 77.78%,75.00%and 72.22%,respectively.The sensitivity of joint detection of three methods was 95.83%,which was better than that of separate detection.Conclusions FRD has the similar diagnostic efficacy with TCT and HPV E6/E7 mRNA,and is conducive to improve sensitivity combined application with TCT and HPV E6/E7 mRNA.Added to the advantages of rapidness and low cost,it has higher promotion significance.