多种子宫颈癌筛查方式的临床应用评价  

Evaluation of clinical application of approaches in cervical cancer screening

作　　者：姜敏[1] 于民[1] 胡新梅[1] 王超[1] 郭国庆[1] 刁兆杰[1] 

机构地区：[1]新疆维吾尔自治区克拉玛依市中心医院病理科,834000

出　　处：《肿瘤研究与临床》2012年第1期31-33,共3页Cancer Research and Clinic

基　　金：克拉玛依市2010年市级科研项目（SK2010.23）

摘　　要：目的评价第二代杂交捕获（HC2）人类乳头状瘤病毒（HPV）检测及液基细胞学检查（LCT）在子宫颈癌筛查中的意义，以指导子宫颈癌筛查方式的选择。方法门诊就诊同时行HC2HPV检测、LCT及病理活组织检查共545例，以病理学结果作为最终诊断，分析HC2HPV检测、LCT、LCT序列试验、HPV序列试验、LCT-HPV平行检测筛查的灵敏度、特异度，评价不同筛查方式在子宫颈癌筛查中的价值。结果545例中病理结果：子宫颈癌10例，子宫颈上皮内瘤变（CIN）3级41例，CIN2级69例，CIN级120例。高危型HPV（HR-HPV）阳性率为64．22％（350／545）；HR-HPV对子宫颈CIN2级以上病变的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为95．83％、4．71％、88．48％、30．68％、99．12％，LCT分别为84．20％、89．53％、85．53％、36．69％、91．76％，LCT序列试验分别为81．03％、95．96％、78-33％、40．69％、92．92％，HPV序列试验分别为81．03％、95．26％、78．33％、42．15％、95．92％，HPV-LCT平行试验分别为99．20％、81．53％、90．03％、32．09％、99．33％。结论HPV－LCT平行检测可显著提高高级别CIN及子宫颈癌诊断的准确性。Objective To evaluate the function of Hybrid capture 2 （HC2） human papillomavirus （HPV） test, liquid-based cytology test （LCT）, HPV serial test, LCT serial test and HPV-LCT parallel test for cervical high grade lesions screening and to guide in selecting the scheme of cervical cancer screening. Methods HPV test, LCT, and colpescopic biopsy were performed in 545 women treated in Centrale Hospital of Klamayi from Sep. 2009 and Dec. 2011. The pathology results were the final diagnosis to evaluate the value of each approach for screening cervical cancer. Results Of 545 patients, 10 had cervical cancer. 41 had cervical intraepithelial neoplasia CIN3, 69 had CIN2, and 120 had CIN 1. Positive rate of high risk HPV was 64.22 %. The sensitivity, specificity, accuracy, positive pre-value, and negative pre-value of HPV test for detecting high-grade cervical lesions were 95.83 %, 84.71%, 88.48 %, 30.68 %, 99.12 %, respectively. The values of LCT were 84.20 %, 89.53 %, 85.53 %, 36.69 %, 91.76 %, respectively. The values of LCT serial test were 81.03 %, 95.96 %, 78.33 %, 40.69 %, 92.92 %, respectively. The values of HPV serial test were 81.03 %, 95.26 %, 78.33 %, 42.15 %, 99.52 %, respectively. The values of HPV-LCT parallel test were 99.20 %, 81.53 %, 90.03 %, 32.09 %, 99.33 %, respectively. Conclusion HPV-LCT parallel test can significantly improve the detection rate of cervical cancer screening.

关 键 词：宫颈肿瘤 人乳头瘤病毒 Ⅱ代杂交捕获 薄层液基细胞学 筛查 

分 类 号：R737.33[医药卫生—肿瘤]