检测尿中巯基筛诊宫颈癌与癌前病变的临床意义  

Clinical significance of testing SH in urine for screening cervical precancerous lesion and cancer

作　　者：刘健[1] Lin Genehun 谢蓉[3] 林安[3] 吴令英[4] 路虹[4] 徐志坚 齐军[6] 吴小华[7] 席晓薇[8] 杨海波 

机构地区：[1]福建省肿瘤医院内科,福州350014 [2]Canada Gamma Dynacare Medical Laboratory [3]福建省肿瘤医院妇科,350014 [4]中国医学科学院肿瘤医院妇瘤科,100021 [5]中国庆学科学院肿瘤医院防癌科,100021 [6]中国医学科学院肿瘤医院榆验科,100021 [7]上海市肿瘤医院妇瘤科,200032 [8]上海市第一人民医院妇瘤科,200080 [9]浙江省仓南县第二医院妇产科,325800

出　　处：《临床肿瘤学杂志》2008年第11期974-978,共5页Chinese Clinical Oncology

摘　　要：目的:评价检测尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌的临床意义。方法:对1030例宫颈癌前病变、早期宫颈癌、中晚期宫颈癌、非宫颈部位的7种癌以及宫颈正常或宫颈良性炎症妇女,采用子宫颈癌快速自检试剂盒(fast self test-SH for screening cervical cancer,FST-SH)检测其尿中巯基。结果:特异度为94.86%;阳性率、准确度、阳性预测值、阴性预测值、约登指数、阳性似然比,在宫颈癌前病变组为35.71%、87.42%、50.00%、91.11%、0.31、6.95;在早期宫颈癌组为65.87%、87.77%、80.58%、89.78%、0.61、12.82;在中晚期宫颈癌组为80.54%、90.24%、88.17%、91.11%、0.75、15.67;在非宫颈部位的7种癌组为12.41%、60.78%、62.96%、60.59%、0.07、2.41。结论:采用子宫颈癌快速自检试剂盒测定尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌患者,阳性率显著高于非宫颈部位的7种癌(P<0.01),且灵敏度随着病情加重而升高(r=0.99,P<0.05)。根据阳性结果判断为宫颈癌前病变或宫颈癌患者具有较高的准确度和阳性预测值及阳性似然比。根据阴性结果区分为非宫颈癌前病变或宫颈癌患者时具有很高的特异性和阴性预测值。因此,该方法适用于筛诊宫颈癌前病变和宫颈癌,但不适用于筛诊非宫颈部位的7种癌。Objective：To evaluate clinical significance of testing sulfhydryl（SH） in urine for screening cervical precancerous lesion and cervical cancer. Methods：Fast self test-SH （FST-SH）was used to test sulfhydryl （SH） in urine of 1030 women with cervical precancerous lesion, early stage （ ≤ⅡA） cervical cancer, middle-late stage （ ≥Ⅱ B ） cervical cancer, 7 kinds of cancers in other sites, normal cervix or benign cervititis. Results：Specificity（Sp） was 94. 86% in FST-SH screening method. Sensitivity（Se）, accuracy （AR） , positive prevalue （PPV） , negative prevalue （ NPV ） , youden index （ YI ） , positive likely-hood ratio （ ＋ LR） of FST-SH for screening cervical precancerous lesion（CIN） was 35.71% ,87.42% , 50. 00% , 91.11% ,0. 31 and 6. 95, respectively, the values for screening early（ ≤ Ⅱ A） cervical cancer were 65.87% ,87. 77% , 80. 58% ,89. 78% ,0. 61 and 12. 82, respectively, and the values for screening middle-late（ ≥ ⅡB） cervical cancer were 80. 54% , 90. 24% , 88.17% ,91.11% ,0. 75 and 15.67, respectively, as well as the values for 7 kinds of cancers in other sites were 12.41% ,60. 78% ,62.96% , 60. 59% ,0.07 and 2.41, respectively. Conclusion：Using FST-SH kit to test SH in urine for screening cervical precancerous lesion, early stage（ ≤ⅡA）cervical cancer, middle-late stage （ ≥Ⅱ B） cervical cancer, Se of the three groups are significantly higher than that of the group with 7 kinds of cancers （ P 〈 0. 01 ） respectively, and it increased with cervical lesions （r = 0. 99 ,P 〈 0. 05 ）. There is better AR, PPV and ＋ LR to judge cervical precancerous lesion or cancer by positive reaction, and excellent Sp and NPV to judge non-cervical precancerous lesion or cancer by negative reaction. FST-SH kit could be used to screen cervical precancerous lesion and cervical cancer, hut it does＇t suitable to screen the another 7 kinds of cancers which is not located in cervix.

关 键 词：宫颈癌前病变 宫颈癌 筛诊 巯基 

分 类 号：R730.43[医药卫生—肿瘤]