TAP与HPV E6/E7、TCT联合应用在不同年龄段宫颈癌筛查中的价值及与组织病理学诊断的一致性

The value of combined detection of TAP,HPV E6/E7 and TCT in cervical cancer screening in different ages and its consistency with histopathological diagnosis

目的探讨肿瘤异常蛋白(TAP)与人乳头瘤病毒(HPV)E6/E7、液基薄层细胞学检查(TCT)联合用于不同年龄段宫颈癌筛查中的价值及与组织病理学诊断的一致性。方法将于中国中医科学院广安门医院南区进行宫颈癌筛查的126例患者纳入研究。根据病理学检查结果,确诊为宫颈癌的57例患者作为宫颈癌组,69例非宫颈癌的宫颈炎症患者作为对照组。对纳入研究对象进行TAP与HPV E6/E7检测及TCT。采用Logistic回归模型得到3种方法联合用于宫颈癌筛查的新变量方程,绘制受试者工作特征(ROC)曲线并分析各种方法单独及联合用于宫颈癌筛查的价值。结果TAP、HPV E6/E7及TCT联合用于宫颈癌筛查的新预测变量方程为Log(P)=0.612TAP+0.631HPV E6/E7+0.628TCT+0.734。TAP、HPV E6/E7及TCT单独及联合用于宫颈癌筛查的曲线下面积(AUC)均大于0.85,其中多种方法联合用于宫颈癌筛查的价值明显高于各方法单独使用(P<0.05)。>40~50年龄段患者TAP、HPV E6/E7检测、TCT结果与组织病理学诊断的一致性均高于90%,且明显高于其他年龄段(P<0.05)。结论TAP与HPV E6/E7、TCT联合用于筛查宫颈癌的AUC明显高于各指标单独应用,其中>40~50岁年龄段与组织病理学诊断的一致性最高。

Objective To investigate the value of tumor abnormal protein(TAP)combined with human papillomavirus(HPV)E6/E7 and thinprep cytologic test(TCT)in cervical cancer screening in different age groups and its consistency with histopathological diagnosis.Methods A total of 126 patients who underwent cervical cancer screening at Guang′anmen Hospital South Area of the Chinese Academy of Chinese Medical Sciences were enrolled in the study.According to the results of pathological examination,57 patients diagnosed with cervical cancer were enrolled as the cervical cancer group,and 69 patients with cervical inflammation and without cervical cancer were enrolled as the control group.TAP and HPV E6/E7 detection and TCT were performed for the people in the study.The Logistic regression model was used to obtain a new variable equation for cervical cancer screening by combining three methods,and the ROC curve was drawn to analyze the value of each method alone and in combination for cervical cancer screening.Results The new variable equation for predicting cervical cancer using TAP,HPV E6/E7 and TCT is Log(P)=0.612TAP+0.631HPV E6/E7+0.628TCT+0.734.The AUC of cervical cancer predicted by TAP,HPV E6/E7 and TCT alone and in combination was greater than 0.85.The value of multiple methods combined for cervical cancer screening was significantly higher than that of each method alone(P<0.05).The consistency of TAP,HPV E6/E7 and TCT with histopathological diagnosis in patients aged>40-50 was higher than 90%,and the consistency of each index in patients aged>40-50 was significantly higher than that in other age groups(P<0.05).Conclusion The AUC of combined detection of TAP,HPV E6/E7 and TCT in screening cervical cancer is significantly higher than that of each index used alone,and the consistency with histopathological diagnosis in>40-50 age group is the highest.