HC2-HPV-DNA联合TCT早期诊断宫颈癌的价值分析  

Value of HC2-HPV-DNA combined with TCT in the early diagnosis of cervical cancer

作　　者：刘金舫[1] 关晓梅 陈素芳 边磊 LIU Jinfang;GUAN Xiaomei;CHEN Sufang;BIAN Lei(Department of Gynecology and Obstetrics, Langfang People＇s Hospital, Langfang 065000, Hebei, China;Department of Gynecology and Obstetrics, Traditional Chinese Medicine Hospital of Gu＇an City, Langfang 065000, Hebei, China)

机构地区：[1]廊坊市人民医院妇产科,河北廊坊065000 [2]廊坊市固安县中医医院妇产科,河北廊坊0650000

出　　处：《癌症进展》2017年第8期917-919,975,共4页Oncology Progress

摘　　要：目的探讨二代杂交捕获法检测高危型人乳头瘤病毒DNA(HC2-HPV-DNA)联合宫颈液基薄层细胞学(TCT)诊断宫颈癌的临床价值。方法选取139例怀疑可能为宫颈癌的患者作为研究对象,分别接受HC2-HPV-DNA、TCT及病理学检查,以病理学检查结果作为诊断依据,计算HC2-HPV-DNA、TCT对宫颈癌的诊断价值。结果 TCT检测共诊断鳞状细胞癌(SCC)16例,其中将4例CINⅢ级患者误诊为SCC患者,6例SCC患者分别误诊为高度鳞状上皮内病变(HSIL)4例、低度鳞状上皮内病变(LSIL)1例、不除外上皮内高度病变的不典型鳞状细胞(ASC-H)1例。慢性宫颈炎患者HC2-HPV-DNA检查阳性率为0%,CINⅠ级患者HC2-HPV-DNA检查阳性率为0%,CINⅡ级患者HC2-HPV-DNA检查阳性率为0%,CINⅢ级患者HC2-HPV-DNA检查阳性率为9.38%,SCC患者HC2-HPV-DNA检查阳性率为77.78%。TCT鉴别诊断宫颈癌的灵敏度为66.67%,特异度为96.69%;HC2-HPV-DNA鉴别诊断宫颈癌的灵敏度为77.78%,特异度为95.87%;HC2-HPV-DNA联合TCT鉴别诊断宫颈癌的灵敏度为83.33%,特异度为89.76%,漏诊率为16.67%,误诊率为10.24%。结论 HC2-HPV-DNA联合TCT诊断宫颈癌能相互弥补检查方法的不足,提高诊断的灵敏度。Objective To investigate the clinical value of hybrid capture II high-risk human papillomavirus DNA（HC2-HPV-DNA） combined with Thin Prep cytology test（TCT） in the diagnosis of cervical cancer. Method 139 cases of suspected cervical cancer patients were included in the study, and were administered with HC2-HPV-DNA, TCT and pathological examination, the value of HC2-HPV-DNA and TCT in the diagnosis of cervical cancer were evaluated with pathological findings as standard reference. Result TCT detected 16 cases of SCC, in which 4 cases of CIN III were misdiagnosed as SCC, another 6 cases of SCC were misdiagnosed as HSIL（4 cases）, LSIL（1 case）, and ASC-H（1 case）; the positive rate of HC2-HPV-DNA in patients with chronic cervicitis was 0%, and in patients with CIN I was 0%, in patients with CIN II was 0%, while it was 9.38% in patients with CIN III, 77.78% in patients with SCC. The sensitivity of TCT in differential diagnosis of cervical cancer was 66.67%, and specificity was 96.69%; and these of HC2-HPV-DNA were77.78% and 95.87%, respectively; the sensitivity of HC2-HPV-DNA combined with TCT in the diagnosis of cervical cancer was 83.33%, the specificity was 89.76%, the rate of missed diagnosis was 16.67%, and the rate of misdiagnosis was10.24%. Conclusion HC2-HPV-DNA combined with TCT improves the efficiency of diagnosis for cervical cancer, with a better diagnostic sensitivity.

关 键 词：第二代杂交捕获法 高危型人乳头瘤病毒 液基薄层细胞学 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]