人乳头瘤病毒快速检测技术与液基薄层细胞检测组合的3种筛查方案在宫颈癌筛查中的比较研究  

A comparative study on three screening methods of combination of HPV rapid detection technology and TCT in cervical cancer screening

作　　者：张媛媛[1] 帕提曼.米吉提 古扎丽努尔.阿不力孜 张璐[1] 

机构地区：[1]新疆医科大学附属肿瘤医院妇科,新疆乌鲁木齐830000

出　　处：《中国妇幼保健》2015年第15期2433-2436,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金项目〔81272335〕

摘　　要：目的:系统评价人乳头瘤病毒快速检测技术(care HPV)与液基薄层细胞检测(TCT)组合的3种宫颈癌筛查方案的效果。方法:对新疆巴楚县5 045例维吾尔族妇女行TCT、care HPV检测,其中675例妇女行阴道镜及活体组织病理检查。比较模拟组合3种人乳头瘤病毒(HPV)与TCT联合方案的灵敏度、特异度、阳性预测值、阴性预测值和ROC曲线下面积。结果:第1种筛查方案:TCT和HPV并联检测方法灵敏度为92.86%(143/154),特异度为33.01%(172/521),阳性预测值为29.07%,阴性预测值为93.99%。TCT和HPV串联检测方法灵敏度为57.79%(89/154),特异度为94.82%(494/521),阳性预测值为76.72%,阴性预测值为88.37%。虽然TCT和HPV并联检测的灵敏度高于串联实验,但串联实验ROC曲线下面积(0.763)大于并联(0.629)。第2种筛查方案:灵敏度为88.12%(89/101),特异度为65.38%(51/78),阳性预测值为76.72%,阴性预测值为80.95%,ROC面积为0.768。第3种筛查方案:灵敏度为67.94%(89/131),特异度为90.94%(271/298),阳性预测值为76.72%,阴性预测值为86.58%,ROC面积为0.794。根据ROC曲线下面积,总体来说第2种、第3种的筛查方案(即分流的筛查方案)优于第1种方案(即TCT与HPV同时检测)。虽然TCT初筛HPV分流方案的灵敏度高于HPV初筛TCT分流方案,但ROC曲线下面积(0.768)低于HPV初筛TCT分流方案的ROC曲线下面积(0.794)。结论:HPV初筛TCT分流的筛查方案对于宫颈癌的筛查最有价值,可作为宫颈癌筛查方案的首选。Objectives： To systematically evaluate the effects of three screening methods of combination of HPV rapid detection technology （care HPV） and Thinprep cytology test （TCT） in cervical cancer screening. Methods： TCT and care HPV were conducted a- mong 5 045 Uygur women in Bachu county in Xinjiang, and 675 women of them underwent colposcopy, biopsy, and pathological examina- tion. The sensitivities, specificities, positive predictive values, negative predictive values, and the areas under ROC curve of three methods were compared. Results： The first screening method： the sensitivity, specificity, positive predictive value, and negative predictive value of parallel connection of TCT and HPV were 92. 86% （ 143/154）, 33. 01% （ 172/521 ）, 29. 07%, and 93. 99%, respectively; the sensitivi- ty, specificity, positive predictive value, and negative predictive value of series connection of TCT and HPV were 57. 79% （ 89/154 ）, 94. 82% （494/521）, 76. 72% , and 88. 37% , respectively. Though the sensitivity of parallel connection of TCT and HPV was higher than that of series connection of TCT and HPV, but the area under ROC curve of series connection of TCT and HPV （0. 763 ） was larger than that of parallel connection of TCT and HPV （0. 629 ） . The second screening method： the sensitivity, specificity, positive predictive value, neg- ative predictive value, and the area under ROC curve were 88. 12% （89/101） , 65.38% （51/78）, 76. 72% , 80.95% , and 0. 768, re- spectively. The third screening method： the sensitivity, specificity, positive predictive value, negative predictive value, and the area under ROC curve were 67. 94% （89/131）, 90. 94% （271/298）, 76. 72% , 86. 58% , and 0. 794, respectively. According to the area under ROC curve, on the whole, the second screening method and the third screening method were better than the first screening method. Though the sensitivity of the second screening method was higher than that of the third screening method, but the area und

关 键 词：宫颈癌 筛查方法 人乳头瘤病毒快速检测技术 液基薄层细胞检测 

分 类 号：R737.33[医药卫生—肿瘤]