液基细胞学检查联合阴道镜检查在宫颈癌筛查中的应用

Application of liquid-based cytology combined with colposcopy in cervical cancer screening

目的:探讨液基细胞学(TCT)检查联合阴道镜检查在宫颈癌筛查中的应用价值。方法:选取行宫颈癌筛查的186例受检者为研究对象,均行高危型人乳头瘤病毒(HR-HPV)、TCT、阴道镜及病理组织学检查;以病理组织学结果为金标准,比较HR-HPV、TCT、阴道镜、TCT联合HR-HPV、TCT联合阴道镜诊断宫颈高级别鳞状上皮内病变及宫颈癌(HSIL+)的临床价值。结果:病理组织学结果显示,186例受检者中,正常或慢性宫颈炎105例,低级别鳞状上皮内病变(LSIL)30例,HSIL40例,鳞状细胞癌(SCC)11例;HR-HPV、TCT、阴道镜、TCT联合HR-HPV、TCT联合阴道镜诊断宫颈HSIL+的受试工作者特征(ROC)曲线下面积(AUC)分别为0.841、0.745、0.834、0.881、0.872,TCT联合HR-HPV、TCT联合阴道镜诊断HSIL+的价值高于三者单独检测(P<0.05);TCT联合HR-HPV、TCT联合阴道镜诊断HSIL+的价值比较,差异无统计学意义(P>0.05)。结论:TCT联合阴道镜诊断HSIL+的价值与TCT联合HR-HPV相近,但该方法费用成本低,在宫颈癌筛查中有较高的应用价值。

Objective:To investigate the application value of liquid-based cytology(TCT) combined with colposcopy in cervical cancer screening.Methods:A total of 186 cases of cervical cancer screening were selected as the research objects, and all of them underwent high-risk human papillomavirus(HR-HPV),TCT,colposcopy and histopathological examination.The clinical values of HR-HPV,TCT,colposcopy, TCT combined with HR-HPV,TCT combined with colposcopy in the diagnosis of high-level squamous intraepithelial lesions and cervical cancer(HSIL+) were compared with the histopathological results as the gold standard.Results:The histopathological results showed that among 186 subjects, 105 cases were normal or chronic cervicitis, 30 cases were low-grade squamous intraepithelial lesion(LSIL),40 cases were HSIL,and 11 cases were squamous cell carcinoma(SCC).The area under the ROC curve(AUC) of HR-HPV,TCT,colposcopy, TCT combined with HR-HPV,TCT combined with colposcopy in the diagnosis of cervical HSIL+was 0.841,0.745,0.834,0.881,0.872,respectively.The value of TCT combined with HR-HPV,TCT combined with colposcopy in the diagnosis of cervical HSIL+was higher than that of the three separate tests(P<0.05).There was no significant difference in the value of TCT combined with HR-HPV and TCT combined with colposcopy in the diagnosis of HSIL+(P>0.05).Conclusion:The value of TCT combined with colposcopy in the diagnosis of HSIL+is similar to that of TCT combined with HR-HPV,but this method has low cost and high application value in cervical cancer screening.