FRD联合Care HPV筛查宫颈病变的临床效果分析

The effective analysis of FRD combined with Care HPV on cervical lesions screening

目的探究叶酸受体介导的宫颈特殊染色(folate receptor-mediated tumor detection,FRD)联合人乳头瘤病毒快速检测(Care HPV)在宫颈病变筛查中的临床应用价值.方法将2020年9月至2021年8月在大同市第一人民医院接受FRD联合Care HPV筛查方案的2000例患者和接受薄层液基细胞学检查(thinprep cytologic test,TCT)联合Aptima HPV筛查方案的2158例患者进行对比,探究两种筛查方案的临床检测效果、并发症、社会经济效果、症状自评效果.结果FRD联合Care HPV组和TCT联合Aptima HPV组在检出率、漏诊率、敏感度、特异度、阳性预测值和阴性预测值(6.40%、4.84%、95.38%、99.47%、92.54%、99.68%vs 5.93%、3.91%、96.24%、99.66%、96.24%、99.75%)之间比较差异无统计学意义(P>0.05);出血率和感染率(32.55%、0.40%vs 49.63%、0.93%)在两组间差异有统计学意义(P<0.05),而人流综合征发生率(0.05%vs 0.14%)在两组间差异无统计学意义(P>0.05);检测时间(6.24±1.25 vs 2.48±0.92)、报告时间(24.00±4.00 vs 72.00±12.00)、检测费用(60.00±21.00 vs 575±100.00)、Zung焦虑自评量表(self-rating anxiety scale,SAS)评分(55.2±10.86 vs 56.02±12.39)和Zung抑郁自评量表(self-rating depression scale,SDS)评分(59.18±14.86 vs 60.02±16.41)在两组间差异有显著统计学意义(P<0.05),而生活质量量表(the 36-item short form health survey,SF-36)评分(63.47±9.36 vs 62.98±12.08)和症状自评量表(symptom check list 90,SCL-90)评分(1.49±0.56 vs 1.46±0.62)在组间差异无统计学意义(P>0.05).结论FRD联合Care HPV与TCT联合Aptima HPV筛查宫颈病变的临床检测效果相当,但前者具有检测费用低廉、报告时间迅速、患者症状自评效果满意度较高等优点,更适合在社区、经济条件和医疗设施相对落后的地区推广.

Objective To investigate the clinical effects of folate receptor-mediated tumor detection(FRD)combined with Care HPV on cervical lesions screening.Methods 2000 cases screened via FRD combined with Care HPV and 2158 cases received thinprep cytologic test(TCT)jointed with Aptima HPV for cervical lesions screening from September 2020 to August 2021 at the First People's Hospital of Datong were compared.The effects of clinical examination,clinical complications,social and economic effects and self-evaluation of symptoms were compared between two groups.Results There were no significant differences in detection rate,misdiagnosis rate,sensitivity rate,specificity rate,positive predictive rate and negative predictive rate between FRD Combined with Care HPV group and TCT Combined with Aptima HPV group(P>0.05).There were significant differences in bleeding rate and the infective rate between the two groups(P<0.05),while there was no statistical significance in the ratio of incomplete abortion syndrome between the two groups(P>0.05).There were significant differences in testing time,reporting time,testing cost,SAS score and SDS score between the two groups(P<0.05),but there was no significant difference in SF-36 score and SCL-90 score between the two groups(P>0.05).Conclusions FRD combined with Care HPV possessed similarly detective effects with TCT combined with Aptima HPV,the detecting cost cheaper,the reported time shorter and the patients'satisfaction with self-evaluation of symptoms higher,which was especially suited to implement in the areas with relatively backward economic conditions and medical facilities.