子宫颈液基细胞学、高危型HPV及联合检测在子宫颈癌机会性筛查中的价值  

Evaluation of cytology and HR-HPV test in cervical lesion opportunistic screening of women

作　　者：赵超[1] 赵昀[1] 崔淑慧[1] 任丽华[1] 王建六[1] 魏丽惠[1] 

机构地区：[1]北京大学人民医院妇产科,100044

出　　处：《中国妇产科临床杂志》2016年第2期119-121,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家卫生计生委科教司公益性行业科研专项(2014PHB019-01)

摘　　要：目的评价宫颈细胞学、高危型HPV及联合检测在宫颈癌机会性筛查中的作用。方法回顾性分析2012年1月至2014年10月在北京大学人民医院妇科门诊行宫颈癌机会性筛查异常行阴道镜检查的女性3 939例的临床资料。结果 1宫颈液基细胞学异常(≥ASC-US)2 632例,阴道镜病理提示宫颈高级别及以上病变(≥CIN2)患者981例,液基细胞学对≥CIN2筛查的灵敏度为77.47%(760/981),特异度为36.71%(1086/2 958),阳性预测值为28.88%(760/2 632),阴性预测值为83.09%(1 086/1 307)。诊断符合率为46.86%(1 846/3 939)。2高危型HPV阳性3268例,阴性671例,病理提示≥CIN2患者1 070例,高危型HPV对≥CIN2筛查的灵敏度为87.66%(938/1 070),特异度为18.79%(539/2 869),阳性预测值为28.70%(938/3 268),阴性预测值为80.33%(539/671)。诊断符合率为37.50%(1 477/3 939)。3液基细胞学和高危型HPV联合检测,液基细胞学异常且高危型HPV阳性2 300例,均阴性339例,病理提示≥CIN2 749例,液基细胞学及高危型HPV均异常对≥CIN2筛查的灵敏度为97.86%(733/749),特异度为17.09%(323/1 890),阳性预测值为31.87%(733/2 300),阴性预测值为95.28%(323/339)。诊断符合率为40.02%(1 056/2 639)。结论细胞学与高危型HPV联合检测对≥CIN2筛查的灵敏度、阳性预测值及阴性预测值均为最高,假阴性率最低,建议在门诊机会性筛查宫颈病变中联合应用细胞学与高危型HPV检测。Objective To evaluate the value of cytology and HR-HPV test（HC-Ⅱ）in cervical lesion opportunistic screening of outpatient women.Methods A total of 3 939 outpatients were opportunistic screened for cervical lesion in Peking University People＇s Hospital from January 2012 to December 2014.Colposcopy and biopsy were carried out with either positive cytology or positive HR-HPV test.Results In the 3 939 women,the sensitivity and specificity of cervical cytology in screening lesions≥CIN2were 77.47%and 36.71%,respectively.The sensitivity and specificity of HR-HPV test in screening lesions≥CIN2were 87.66% and 18.79%,respectively.The sensitivity and specificity of cytology and HR-HPV test in screening lesions≥CIN2were 97.86%and 17.09%,respectively.Conclusion Combined screening method of cytology and HR-HPV test was recommended in cervical lesion opportunistic screening for outpatient women.

关 键 词：宫颈癌筛查 宫颈细胞学 高危型人乳头瘤病毒 联合筛查 

分 类 号：R737.33[医药卫生—肿瘤]