健康体检宫颈癌筛查中TCT与HPV联合检测的应用

Application of Combined Detection of TCT and HPV in Cervical Cancer Screening

目的:分析在健康体检宫颈癌筛查中TCT与HPV联合检测的临床价值。方法:从2021年1月~2021年12月择取3923例健康体检宫颈癌筛查妇女,所选研究对象均实施TCT检查,并行HPV检查,以阴道镜下宫颈病理组织活检结果为金标准,对单独TCT检查、单独HPV检查以及TCT联合HPV检查的检测结果及临床价值进行对比分析。结果:3923例健康体检者中,186例疑似宫颈癌,6例经阴道镜下宫颈病理组织活检确诊为阳性,180例为阴性。在TCT检查中,4例确诊为阳性,54例阴性。在HPV检查中,5例确诊为阳性,72例阴性。在TCT联合HPV检查中,6例确诊为阳性,162例阴性。TCT联合HPV检查的阳性检出率明显高于单独TCT检查、单独HPV检查,差异有统计学意义(P<0.05);单独TCT检查、单独HPV检查的阳性检出率对比差异无统计学意义(P>0.05)。从临床价值分析,单独TCT检查的敏感度为66.67%,特异度为30.00%,符合率31.18%,单独HPV检查的敏感度为83.33%,特异度为40.00%,符合率41.40%,TCT联合HPV检查的敏感度为100%,特异度为90.00%,符合率90.32%,TCT联合HPV检查的敏感度、特异度以及符合率均高于单独TCT检查、单独HPV检查,差异有统计学意义(P<0.05)。单独TCT检查、单独HPV检查的敏感度、特异度以及符合率对比差异无统计学意义(P>0.05)。结论:在健康体检宫颈癌筛查中,TCT与HPV联合检测可以提高阳性检出率,使单一检测的不足和缺陷得到弥补,而且操作简单,具备较高的敏感度和特异度,临床价值显著。

Objective:To analyze the clinical value of combined detection of TCT and HPV in cervical cancer screening.Methods:From January 2021 to December 2021,3923 healthy women were selected for cervical cancer screening.All the selected subjects underwent TCT examination and HPV examination.The results of cervical biopsy under colposcopy were taken as the gold standard.The detection results and clinical value of TCT alone,HPV alone and TCT combined with HPV were compared and analyzed.Results:Among 3923 healthy subjects,186 cases were suspected of cervical cancer,6 cases were confirmed positive by colposcopy and 180 cases were negative.On TCT examination,4 cases were confirmed positive and 54 cases were negative.In the HPV test,five cases were confirmed positive and 72 were negative.In TCT combined with HPV testing,6 patients were confirmed positive and 162 were negative.The positive detection rate of TCT combined with HPV examination was significantly higher than that of TCT examination alone and HPV examination alone(P<0.05).There was no significant difference in the positive detection rate between TCT examination alone and HPV examination alone(P>0.05).From the analysis of clinical value,the sensitivity of TCT alone was 66.67%,the specificity was 30.00%,the coincidence rate was 31.18%,the sensitivity of HPV alone was 83.33%,the specificity was 40.00%,the coincidence rate was 41.40%,the sensitivity of TCT combined with HPV examination was 100%,the specificity was 90.00%.The coincidence rate was 90.32%.The sensitivity,specificity and coincidence rate of TCT combined with HPV examination were higher than those of TCT examination alone and HPV examination alone,and the differences were statistically significant(P<0.05).There was no significant difference in sensitivity,specificity and coincidence rate between TCT alone and HPV alone(P>0.05).Conclusion:In cervical cancer screening,TCT combined with HPV detection can improve the positive detection rate,make the deficiencies and defects of a single test be fully realized,and the operation is simple,has high sensitivity and specificity,and has significant clinical value.