宫颈癌筛查风险评估量表在体检人群宫颈癌及高度鳞状上皮内病变筛查中的应用价值

The application value of cervical cancer screening Risk assessment Scale in screening cervical cancer and high squamous intraepithelial lesions

目的研究宫颈癌筛查风险评估量表(CSRAS)在体检人群宫颈癌及高度鳞状上皮内病变筛查中的应用价值。方法选取通过病理检查确诊的60例宫颈癌及高度鳞状上皮内病变患者,采取液基薄层细胞学检查(TCT)、人乳头瘤病毒(HPV)及其联合CSRAS进行检查,观察其筛查价值。结果TCT并联HPV和病理诊断、TCT串联HPV和病理诊断、HPV和病理诊断、TCT和病理诊断、CSRAS量表和病理诊断的Kappa值分别为0.162、0.259、0.075、0.379、0.456。CSRAS量表的诊断敏感度低于TCT并联HPV法,高于TCT串联HPV法(P<0.05),CSRAS量表的准确率高于HPV、TCT并联HPV法(P<0.05);CSRAS量表和TCT、TCT串联HPV的准确率比较,差异无统计学意义(P>0.05)。结论宫颈癌及高度鳞状上皮内病变的筛查中应用宫颈癌筛查风险评估量表进行筛查,可有效提高筛查效能,值得临床推广。

Objective To study the application value of cervical cancer screening risk assessment scale(CSRAS)in screening for cervical cancer and high squamous intraepithelial lesions.Methods 60 patients with cervical cancer and high squamous intraepithelial lesions confirmed by pathological examination were selected and examined by liquid based cytology(TCT),human papillomavirus(HPV)and its combined CSRAS to observe the screening value,Results The Kappa values of TCT parallel HPV and pathological diagnosis,TCT tandem HPV and pathological diagnosis,HPV and pathological diagnosis,TCT and pathological diagnosis,CSRAS scale and pathological diagnosis were 0.162,0.259,0.075,0.379 and 0.456,respectively.The diagnostic sensitivity of CSRAS scale was lower than that of TCT parallel HPV method,but higher than that of TCT tandem HPV method(P<0.05),and the accuracy of CSRAS scale was higher than that of HPV and TCT parallel HPV method(P<0.05).There was no significant difference between the accuracy of CSRAS scale,TCT and TCT tandem HPV(P>0.05).Conclusion In the screening of cervical cancer and high squamous intraepithelial lesions,the application of cervical cancer screening risk assessment scale can effectively improve the screening efficiency and is worthy of clinical promotion.