宫颈癌筛查系统不同点探区间在宫颈癌筛查中的应用价值  

Value of different target area in TruScreen system for the screening of cervical cancer

作　　者：李伟宏[1] 凌奕[1] 张峻霄[1] 牛海燕[2] 吴小妹[1] 陈华[1] 曾蓉蓉[1] 王丽[1] 金松[1] 

机构地区：[1]海南医学院附属医院妇产科,海南海口571100 [2]海南医学院附属医院病理科,海南海口571100

出　　处：《海南医学院学报》2011年第9期1171-1174,共4页Journal of Hainan Medical University

基　　金：海南省卫生厅科研项目(琼卫2009-64)~~

摘　　要：目的:评价宫颈癌筛查系统不同点探区间在宫颈癌筛查中的应用价值。方法:取液基薄层细胞检测(TCT)为不典型鳞状细胞(ASCUS)及以上病例50例,用宫颈癌筛查系统进行15～20点、21～32点及2种不同点数的联合检测,再与宫颈活检病理学结果阳性病例进行对比研究。结果:病理学检测结果异常者21例,其中子宫颈上皮内瘤变(CINⅠ)10例,CINⅡ6例,CINⅢ4例,浸润癌1例。宫颈癌筛查系统15～20点探检测阳性率为56.00%(28/50),敏感度为76.19%(16/21),特异度为58.62%(17/29);宫颈癌筛查系统21～32点探阳性率为70.00%(35/50),敏感度为90.48%(19/21),特异度为44.83%(13/29);宫颈癌筛查系统15～20点与21～32点联合点探阳性率为48.00%(24/50),剔除2种点探结果不一致病例20例,漏检病理学异常病例8例,其敏感度为84.62%(11/13),特异度为35.29%(6/17)。与病理学符合率分别为66.00%、64.00%和56.67%,一致性检验结果Kappa分别为0.49、0.54、0.53,差异均有统计学意义(P均<0.01)。2种方法联合检测结果异常时均为CINⅡ以上高级别病变。结论:宫颈癌筛查系统与病理学诊断结果有较好的一致性,2种点探区间联合检测结果均异常时提示有高级别病变的存在。Objective： To evaluate the value of different target area in TruScreen system for the screening of cervical cancer.Methods： A total of 50 cases that were confirmed as ASCUS or above according to TCT were enrolled in this study.And diagnosis results of detecting 15-20 points,21-32 points,or the combination of the two were compared with pathological detection results to evaluate their accuracy.Results： 21 cases of pathological detection revealed abnormal results in 21 cases,of which 10 were CINⅠ,6 were CINⅡ,and 4 were CINⅢ,1 case was invasive carcinoma.Detection of 15-20 points with truescan system showed positive rate of 56%（28/50）,with a sensitivity of 76.19%（16/21）and specificity of 58.62%（17/29）.Detection of 21-32 points showed positive rate of 70%（35/50） showing sensitivity of 90.48%（19/21） and the specificity of 44.83%（13/29）.Combined detection of the two areas showed positive rate of 48%（24/50）.Excluding 20 cases with different results according to the two detecting methods,there were 8 false negative cases,showing sensitivity of 84.62%（11/13）,specificity of 35.29%（6/17）,and the rate of unanimous results was 66%,64% and 56.67%,respectively（P0.01）.Conclusions： The TruSystem shows great diagnosis accuracy according to pathological detection.Abnormal results of both detecting areas indicate high degree of lesions.

关 键 词：宫颈癌筛查系统 宫颈病变 病理检查 

分 类 号：R737.33[医药卫生—肿瘤]