叶酸受体新技术及细胞学检查对宫颈癌筛查应用价值的评估  

Evaluation of the application of folate receptor mediated （FRD） multifunctional acetic acid white solution inspection with liquid based cytology screening for cervical cancer

作　　者：邓翠[1] 康佳丽[1] 蒋文燕[1] 聂妙玲[1] 黄晓晖[2] 

机构地区：[1]广州医科大学附属广州市第一人民医院妇产科,广州510180 [2]广东省妇幼保健院

出　　处：《中国医师杂志》2014年第8期1064-1067,共4页Journal of Chinese Physician

摘　　要：目的 探讨叶酸受体介导（FRD）多功能醋酸白溶液检查和液基细胞学检查（TCT）在宫颈癌筛查中的应用价值.方法 对602例患者行FRD多功能醋酸白溶液检查、TCT及宫颈活检病理学检查,以组织病理学结果为金标准,对照分析FRD多功能醋酸白溶液检查和TCT筛查的诊断价值.结果 602例患者经宫颈活检病理学检查,其阳性率21.8％ （131/602）,其中CIN Ⅰ级36例,CINⅡ级41例,CINⅢ级24例,宫颈浸润癌30例.FRD多功能醋酸白溶液筛查,其阳性率23.8％（143/602）,两者阳性结果比较差异无统计学意义（P＞0.05）;FRD多功能醋酸白溶液筛查炎症和宫颈浸润癌漏诊率分别为2.6％、21.1％,CIN误诊率3.8％.TCT筛查炎症漏诊率7.2％,CIN Ⅰ误诊率5.3％、CINⅡ漏诊率4.9％,CINⅢ误诊率58.6％,而鳞状细胞癌（SCC）及腺癌（AC）检出符合率为100％.FRD多功能醋酸白溶液检查、TCT检查的敏感度分别为80.92％、90.84％,特异度分别为92.14％、90.23％,两者比较差异均无统计学意义（P＞0.05）;阳性预测值分别为74.13％、72.12％,阴性预测值分别为95.59％、97.25％,两者比较差异均无统计学意义（P＞0.05）.结论 两种筛查宫颈病变及宫颈癌的效率及评价相近似,而FRD多功能醋酸白溶液检查对宫颈管深部病变检测受限,则不能完全代替TCT检查.但FRD多功能白色醋酸溶液检测方法可靠,且经济又操作简单,适合基层医院宫颈癌普查.Objective To explore the folate receptor mediated （FRD） check and multi-function acetic acid white solution liquid based cervical cytology （TCT） application value in cervical cancer screening.Methods A total of 602 cases of patients was tested with FRD multi-function acetic acid white solution check,and TCT and cervical biopsy pathology examination.With the used of histopathological results as the gold standard,FRD multi-function acetic acid white analysis was compared with the TCT screening inspection results.Results For a total 602 patients with TCT screening,the positive rate was 21.8％ （131/602）,including 36 cases of CIN Ⅰ level,41 cases of CIN Ⅱ level,24 cases of CIN Ⅲ level,and 30 cases of cervical invasive carcinoma.For the FRD multifunction white acetate solution screening,its positive rate was 23.8％ （143/602）.No statistically significant difference was found between TCT and FRD screening （P ＞ 0.05）.The missed diagnosis rate of FRD multi-function white acetate solution screening was 2.6％ in inflammation,and 21.1％ in cervical invasive cancer,and 3.8 ％ in CIN.The missed diagnosis rate of TCT screening was 7.2％ in inflammation,5.3％ in CIN Ⅰ,4.9％ in CIN Ⅱ,and 58.6％ in CIN Ⅲ]; whereas,its detection coincidence rate was 100％ in squamous cells carcinoma （SCC） and adenocarcinoma （AC）.FRD multi-function acetic acid white solution screening had a sensitivity 80.92％,specificity 92.14％,positive predictive value 74.13％,and negative predictive value 95.59％.TCT examination had a sensitivity 90.84％,specificity 90.23％,positive predictive value 72.12％,and negative predictive value 97.25％.No significant difference was found between FRD and TCT methods （P ＞ 0.05）.Conclusions FRD and TCT methods were both efficient in screening and evaluation for cervical lesions and cervical cancer.Because FRD method is limited in the deep tube for examination of cervical lesions; it cannot completely replace the TCT examination.However,FRD method is reliable,

关 键 词：宫颈肿瘤/诊断 普查 叶酸 细胞学技术 

分 类 号：R737.33[医药卫生—肿瘤]