液基薄层细胞学检查联合人乳头瘤病毒检测对早期宫颈癌的诊断价值

Diagnostic value of thin-prep cytology test combined with human papilloma virus detection in early cervical cancer

目的 探讨液基薄层细胞学检查(TCT)联合人乳头瘤病毒(HPV)检测对早期宫颈癌的诊断价值。方法收集90例宫颈癌筛查患者的临床资料,分别对患者进行TCT、HPV和病理学检查,以病理学检查结果为金标准,比较TCT、HPV单独和联合检测对不同宫颈疾病的检出率及对早期宫颈癌的诊断价值。结果 经病理学检查证实,宫颈癌78例,宫颈炎6例,低级别宫颈上皮内瘤变2例,高级别宫颈上皮内瘤变4例。TCT、HPV、TCT+HPV对不同宫颈疾病的检查结果与病理学检查结果的一致性均较好(Kappa=0.626、0.485、0.832,P﹤0.01),但TCT+HPV检测结果与病理结果的一致性更高。TCT+HPV检测诊断早期宫颈癌的灵敏度、阳性预测值、阴性预测值最高,分别为91.03%、93.42%、50.00%,且TCT诊断早期宫颈癌的灵敏度、特异度、阴性预测值及阳性预测值均高于HPV检测。结论 TCT、HPV联合应用对早期宫颈癌的诊断价值较高,适用于早期宫颈癌的筛查。

Objective To investigate the diagnostic value of thin-prep cytology test(TCT)combined with human papilloma virus(HPV)detection in early cervical cancer.Method The clinical data of 90 cervical cancer screening patients were collected.TCT,HPV,and pathology examination were examined separately.Pathological examination was the gold standard.The detection rate of TCT and HPV alone and in combination for different cervical diseases and the diagnostic value of early cervical cancer were also compared.Result Pathological examination confirmed that there were 78 cases of cervical cancer,6 cases of cervicitis,2 cases of low-grade cervical intraepithelial neoplasia,and 4 cases of high-grade cervical intraepithelial neoplasia.TCT,HPV,TCT+HPV had good consistency between the examination results and pathological examination results of different cervical diseases(Kappa=0.626,0.485,0.832,P<0.01),however,TCT+HPV test results were more consistent with pathological results.TCT+HPV detection had the highest sensitivity,positive predictive value and negative predictive value for early cervical cancer,which were 91.03%,93.42%and 50.00%,respectively,and the sensitivity,specificity,negative predictive value and positive predictive value of TCT in the diagnosis of early cervical cancer were higher than those of HPV detection.Conclusion The combined application of TCT and HPV has high diagnostic value for early cervical cancer and is suitable for screening of early cervical cancer.