人乳头状瘤病毒DNA联合薄层液基细胞学检查在宫颈癌及早期宫颈病变筛查中的价值  

Value of human papillomaviruses DNA detection combined with Thinprep liquid cytologic test to cervical cancer screening

作　　者：王勇[1] 张蔚[1] 黄玥[1] 刘珍[1] 

机构地区：[1]武汉大学人民医院妇科,武汉430060

出　　处：《中华实用诊断与治疗杂志》2015年第11期1125-1127,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：湖北省自然科学基金(2013CFB232)

摘　　要：目的比较薄层液基细胞学(Thinprep liquid cytologic test,TCT)单独及联合人乳头状瘤病毒(human papillomaviruses,HPV)-DNA检测在宫颈癌及宫颈早期病变筛查中的价值。方法宫颈病变患者673例,均行TCT、HPV-DNA检测及宫颈组织活检病理检查,以组织病理结果为诊断标准,计算并比较TCT与TCT联合HPV-DNA诊断宫颈癌及宫颈早期病变的灵敏度和特异度。结果组织活检病理诊断宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅰ级76例,CINⅡ级92例,CINⅢ级59例,宫颈鳞癌33例,共260例;TCT诊断宫颈癌及宫颈早期病变249例,经组织病理证实180例,诊断灵敏度为69.2%(180/260),特异度为83.3%(344/413);HPV-DNA诊断宫颈癌及宫颈早期病变296例,经组织病理证实191例,诊断灵敏度为73.5%(191/260),特异度为79.4%(328/413);HPV联合TCT诊断265例,经组织病理证实216例,诊断灵敏度为83.1%(216/260),特异度为88.1%(364/413);HPV-DNA联合TCT诊断灵敏度、特异度高于单独TCT或HPV-DNA检测,差异有统计学意义(P<0.05)。结论与单独应用TCT检查比较,在宫颈癌及宫颈早期病变筛查中联合检测HPV-DNA与TCT可提高诊断灵敏度和特异度。Objective To investigate the value of human papillomaviruses （HPV）-DNA testing combined with Tbinprep liquid cytologic test （TCT） to the cervical cancer screening. Methods A total of 673 cases received TCT, HPV-DNA testing and pathological examinations to calculate the sensitivity and specificity of TCT, HPV-DNA testing, TCT ＋ HPV-DNA, and HPV-DNA -- pathological examination for the diagnosis of cervical cancer and early lesions. Results Of 673 cases, 260 cases were confirmed positive by pathological examinations, including 76 cases of CIN I , 92 cases of CIN II , 59 cases of CINIII, and 33 cases of cervical cancer. TCT diagnosed cervical cancer and early lesions in 249 cases, in which 180 cases were consistent with the results of pathological examinations, with the sensitivity of 69.2 % （180/260） and specificity of 83.3% （344/413）. HPV-DNA diagnosed cervical cancer and early lesions in 296 cases, in which 191 were consistent with the results of pathological examinations, with the sensitivity of 73.5 % （191/260） and specificity of 79.4% （328/413）. The joint detection of TCT and HPV-DNA diagnosed cervical cancer and early lesions in 265 cases, in which 216 cases were confirmed by pathological examination, with the sensitivity of 83.1 % （216/260） and specificity of 88.1 % （364/413）, significantly higher than those of either TCT or HPV-DNA （P〈0.05）. Conclusion Compared with TCT test, the joint detection of HPV-DNA and TCT can improve the sensitivity and specificity for screening cervical cancer and early lesions.

关 键 词：宫颈癌 宫颈早期病变 液基细胞学 人乳头状瘤病毒-DNA 

分 类 号：R737.33[医药卫生—肿瘤]