高危型HPV联合TCT检查在宫颈上皮内瘤变筛查中的应用价值

Application Value of High-risk HPV Combined with TCT Examination in the Screening of Cervical Intraepithelial Neoplasia

目的:分析高危型人乳头瘤病毒(HPV)联合液基薄层细胞学检测(TCT)检查在宫颈上皮内瘤变(CIN)筛查中的应用价值。方法:选取2020年5月—2021年5月于中国人民解放军陆军第七十三集团军医院行CIN筛查的103例妇女为研究对象。所有研究对象进行高危型HPV及TCT检查。以病理检查为“金标准”,比较不同检查方法诊断CIN的结果及效能。分析高危型HPV联合TCT检查与病理检查诊断CIN的一致性。结果:103例研究对象中57例经金标准证实为CIN。高危型HPV联合TCT检查的敏感度、准确度及阴性预测值均高于高危型HPV、TCT单独检查,差异均有统计学意义(P<0.05)。三种检查方法特异度及阳性预测值比较差异均无统计学意义(P>0.05)。Kappa检验显示,高危型HPV联合TCT检查CIN与病理检查结果的一致性较好(Kappa=0.883,P=0.000)。结论:高危型HPV联合TCT检查在CIN的筛查中效果显著,具有较高的敏感度与准确度、阴性预测值,可于早期及时发现CIN,以指导临床治疗。

Objective: To analyze the application value of high-risk human papilloma virus(HPV) combined with thinprep cytologic test(TCT) examination in the screening of cervical intraepithelial neoplasia(CIN). Method: A total of 103 women who underwent CIN screening in the 73rd Army Group Hospital of the Chinese People’s Liberation Army from May 2020 to May 2021 were selected as the research objects. All research objects underwent high-risk HPV and TCT examination. Pathological examination was used as the "gold standard" to compare the efficacy and result of different examination methods in the diagnosis of CIN. The consistency of high-risk HPV combined with TCT examination and pathological examination in the diagnosis of CIN was analyzed. Result: Fiftyseven of 103 research objects were diagnosed as CIN by gold standard. The sensitivity, accuracy and negative predictive value of highrisk HPV combined with TCT examination were higher than those of high-risk HPV and TCT alone examination, and the differences were statistically significant(P<0.05). There were no significant differences in the specificity and positive predictive value between the three examination methods(P>0.05). The Kappa test showed that the consistency between high-risk HPV combined with TCT examination and pathological examination results was better(Kappa=0.883, P=0.000). Conclusion: High-risk HPV combined with TCT examination has a significant effect in the screening of CIN, with high sensitivity, accuracy and negative predictive value, which can be used to detect CIN early and timely, so as to guide clinical treatment.