叶酸受体介导靶向肿瘤检测技术用于宫颈癌快速筛查的临床应用研究  

Clinical application of folic acid receptor- mediated diagnosis for rapid cervical cancer screening

作　　者：花茂方[1] 陈燕娟 俞双华[1] HUA Maofang;CHEN Yanjuan;YU Shuanghua(The Maternal and Child Health Care Hospital of Lianyungang, Lianyungang, Jiangsu 222006, Chin)

机构地区：[1]连云港市妇幼保健院,江苏连云港222006

出　　处：《徐州医科大学学报》2018年第3期194-197,共4页Journal of Xuzhou Medical University

基　　金：江苏省六大高峰人才项目（11-DSWYY-049）

摘　　要：目的探究叶酸受体介导靶向肿瘤检测技术（FRD）在宫颈癌筛查中的临床应用价值。方法随机选取妇科门诊患者3358例，分为叶酸受体介导靶向肿瘤检测技术组（FRD组，n=2105）和液基薄层细胞技术组（TCT组，n=1253），FRD／TCT检测结果阳性者行阴道镜检查并取活检，于FRD／TCT检测阴性人群中随机抽取10％作为对照并行阴道镜评估，以病理诊断为金标准评价FRD在宫颈癌筛查中的价值。结果FRD检测阳性者为234例，检出率为11．12％；TCT检测阳性者为162例，检出率为12．93％；以CINII为病理阳性分界，FRD组活检病例共422例，FRD敏感性82．83％，特异度52．94％，阳性预测值35．04％，阴性预测值90．96％；TCT组活检病例271例，TCT敏感性76．00％，特异度46．43％，阳性预测值35．19％，阴性预测值83．49％。两种检测方法所得数据特异度，阳性预测值，阴性预测值比较，差异无统计学意义（P〉0．05），2组敏感性比较，差异有统计学意义（P〈0．05）。结论FRD是一种简单的宫颈染色技术，操作简单，诊断时效高。与TCT相比，检测敏感性更高，适合推广应用。Objective To investigate the clinical application of folic acid receptor - mediated diagnosis （FRD） for cervical cancer screening. Methods A total of 3358 outpatients of Department of Gynaecology were randomly selected and then divided into two groups ： a FRD group （ n = 2 105 ） and a liquid - based thin - layer cytology technique （TCT） group （n = 1 253 ）. Patients with positive FRD/TCT testing results underwent colposcopy and biopsy, while 10% of those with negative FRD/TCT results were randomly as controls and received colposcopic evaluation. Then, the application of FRD in the diagnosis of cervical lesion screening was evaluated using pathological diagnosis as the gold standards. Results There were 234 FRD positive patients （ 11.12% ）, and 162 TCT positive patients （ 12.93% ）. The pathologi- cally positive standard was cervical intraepithelial neoplasia （CIN） If. In the FRD group, 422 patients underwent biop- sy, with 82.83% sensitivity, 52.94% specificity, and a positive predictive value of 35.04% and a negative predictive value of 90.96%. For the TCT group, 162 patients underwent biopsy, with 76.00% sensitivity, 46.43% specificity, and a positive predictive value of 35.19% and a negative predictive value of 83.49%. There was no significant difference in specificity, positive and negative predictive values between the two methods （ P 〉 0.05 ）. However, statistical differ- ence was found as to sensitivity between the two groups （ P 〈 0.05 ）. Conclusions FRD is a simple cervical staining technique with simple procedures and high diagnostic efficiency. Compared with TCT, it has good detection sensitivity and is suitable for application.

关 键 词：宫颈癌 快速筛查 叶酸受体 肿瘤靶向检测 液基薄层细胞技术 

分 类 号：R713[医药卫生—妇产科学]