子宫颈癌早期筛查多种方法的比较分析  

Comparison of several methods of early screening for cervical cancer

作　　者：宋伟[1] 

机构地区：[1]太原钢铁(集团)有限公司总医院妇产科,030003

出　　处：《肿瘤研究与临床》2007年第5期323-325,共3页Cancer Research and Clinic

摘　　要：目的探讨子宫颈癌早期筛查的最佳方法。方法选取2005年5月至2006年7月,太原钢铁(集团)有限公司总医院妇产科门诊接诊病例100例,以病理检查作为金标准,采用肉眼观测辅以醋酸和碘试验、阴道镜检查、液基细胞学检查(TCT法)、杂交捕获二代法(HC-Ⅱ法)HPV DNA检测等几种常用方法,对比其特异度(Sp)、敏感度(Se)、准确度(E)、阳性预测值(PPV)、阴性预测值(NPV)。结果几种检测方法Sp、Se、E、PPV、NPV,肉眼观测辅以醋酸和碘试验依次为31.13%、71.43%、74.00%、6.69%、92.95%,阴道镜检查依次为33.43%、93.39%、86.00%、21.20%、96.65%,TCT法依次为69.87%、95.08%、95.45%、67.98%、95.78%。HC-Ⅱ法HPV DNA依次为99.87%、84.65%、88.71%、33.00%、99.06%。结论肉眼观测辅以醋酸和碘试验法联合应用阴性预测值高,阴道镜检测不适用于早期筛查。Objective To explore the best program of the early screening for cervical cancer.Methods From May,2005 to July,2006,100 cases were detected with visual inspection(assisted with iodine and acetic acid test),colpescopy,thinprep cytologic test and HC-Ⅱfor HPV DNA test.Biopsy was used as golden crite- ria.The sensitivity(Se),specificity(Sp),effficiency(E),positive predictive value(PPV),negative predictive value (NPV)of the several methods were compared.Results Using biopsy result as a golden standard,the sensitivi- ty,specificity,efficiency,PPV,NPV of each diagnostic test were respectively listed as follows,visul inspection 31.13%,71.43%,74.00%,6.69%,92.95%,Colposcopy 33.43%,93.39%,86.00%,21.20%,96.65%, Thinprep Pap 69.87%,95.08%,95.45%,67.98%,95.78%,HC-Ⅱfor HPV test 99.87%,84.65%, 88.71%,33.00%,99.06%.Conclusion The diagnostic value of visual inspection is very low;Thinprep cy- tology and HC-Ⅱfor HPV test are suitable for cervical cancer screening test;NPV is very high if two methods are combined for early screening test;colposcope is not suitable for early screening test but a diagnostic method.

关 键 词：宫颈肿瘤 早期诊断 细胞学 乳头状瘤病毒 人 阴道镜检查 

分 类 号：R737.33[医药卫生—肿瘤]