HPV分型联合液基薄层细胞学检查对宫颈癌及癌前病变的诊断价值

Diagnostic Value of HPV Typing Combined with Liquid-Based Thin-layer Cytology in Cervical Cancer and Precancerous Lesions

目的探讨人乳头瘤状病毒(HPV)联合液基薄层细胞学(TCT)对宫颈癌(SCC)及癌前病变(CIN)的诊断价值。方法选取接受SCC筛查的患者456例作为研究对象,其中疑似SCC患者148例,设为SCC组,疑似CIN患者308例,设为CIN组,入选者均行HPV分型和TCT检查,以手术病理检查结果作为“金标准”,观察手术病理学诊断结果,分别记录TCT及HPV分型单独及联合检测的诊断效能。结果SCC组、CIN组HPV分型与TCT两者结合检测假阳性率和假阴性率均低于HPV分型与TCT单独检测(χ^(2)=5.473、11.501、8.308、13.000、16.055、25.437、11.418、16.730,P<0.05);SCC组、CIN组HPV分型和TCT联合检测特异度、敏感度及准确度均高于两者单独检测(χ^(2)=5.473、11.501、8.308、11.999、13.000、22.087、16.055、11.418、27.435、25.437、19.351、16.730,P<0.05)。结论TCT联合HPV分型检测对SCC及CIN筛查检出率较高,诊断效能较好,优于两者单独检测。

Objective To explore the diagnostic value of human papilloma virus(HPV)combined with thinprep cytologic test(TCT)in squamous cell carcinoma(SCC)and cervical intraepithelial neoplasia(CIN).Methods 456 patients who received SCC screening were selected as the research object,including 148 suspected SCC patients,who were set as SCC group and 308 suspected CIN patients,who were set as CIN group.All selected patients underwent HPV typing and TCT examination,and the results of surgical and pathology examination were taken as the"gold standard"to observe the results of surgical pathology diagnosis,and the diagnostic value and efficacy of TCT and HPV typing alone and in combination were recorded.Results The false-positive rate and false-negative rate of both HPV typing and TCT combined detection in SCC and CIN groups were lower than that of HPV typing and TCT alone detection(χ^(2)=5.473、11.501、8.308、13.000、16.055、25.437、11.418、16.730,P<0.05).The specificity,sensitivity and accuracy of both HPV typing and TCT combined detection in the SCC group and CIN group were higher than those of the two independent detections(χ^(2)=5.473、11.501、8.308、11.999、13.000、22.087、16.055、11.418、27.435、25.437、19.351、16.730,P<0.05).Conclusion TCT combined with HPV typing has higher detection rate and better diagnostic efficacy in cervical cancer and CIN screening,which is better than the two tests alone.