液基脱落细胞学检查联合HPV及P16检查在宫颈癌早期诊断中的对比研究  

Comparative study of TCT and TCT combined with HPV and P16 detections in the early diagnosis of cervical cancer

作　　者：张功学[1] 丁凯[1] 齐峰[1] 杨阳[1] 詹义凤[1] 马飞[1] ZHANG Gong- xue;DING Kai;QI Feng;YANG Yang;ZHAN Yi -feng;MA Fei(Pathology Department, the First People＇s Hospital of Zaoyang, the Affiliated Hospital of Hubei Arts and Science College, Zaoyang, Hubei 441200, China)

机构地区：[1]枣阳市第一人民医院湖北文理学院附属医院病理科,湖北枣阳441200

出　　处：《中国卫生检验杂志》2018年第7期851-854,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨液基脱落细胞学检查(TCT)及其联合人乳头状瘤病毒(HPV)、P16蛋白免疫组化染色检测对早期宫颈癌的筛查价值。方法对TCT和HPV检测至少有一项异常的700例患者,进行P16免疫细胞染色,同时行阴道镜活组织检验作为标准,以此评价TCT及其联合HPV、P16检测对于诊断早期宫颈癌病变的意义。结果 TCT检测灵敏度为76.33%,特异度为57.41%,准确性为67.57%,TCT+HPV+P16检测的灵敏度为90.15%,特异度为86.11%,准确性为88.29%,均高于TCT检测,差异有统计学意义(P<0.05)。TCT检测与病理组织学诊断结果一致性较差(Kappa=0.341,P<0.05)。TCT+HPV+P16检测与病理组织学诊断结果一致性较好(Kappa=0.764,P<0.05)。结论 TCT联合HPV及P16检查可提高早期宫颈癌筛查的灵敏度和特异度,对宫颈癌的早期防治有重大意义。Objective To investigate the value of immunohistochemical staining of liquid-based exfoliative cytology（TCT）combined with the detection of human papillomavirus（HPV）and P16 protein in the early diagnosis of cervical cancer.Methods The 700 patients with at least one of the abnormalities of TCT and HPV were conducted for P16 immunocytochemistry and colposcopic biopsy.Colposcopic biopsy was performed as a standard to evaluate the significance of TCT detection combined with HPV and P16 in the diagnosis of early cervical cancer.Results The sensitivity of TCT detection was 76.33%,the specificity was 57.41%,and the accuracy was 67.57%.The sensitivity of TCT ＋ HPV ＋ P16 was 90.15%,the specificity was 86.11%,the accuracy was 88.29 %.They were significantly higher than TCT test,and the differences were statistically significant（P〈0.05）.TCT detection and histopathological diagnosis of consistency was not good（Kappa = 0.341,P〈0.05）.TCT ＋ HPV ＋ P16 detection had good consistency with histopathological diagnosis（Kappa = 0.764,P〈0.05）.Conclusion TCT combined with HPV and P16 detection can improve the sensitivity and specificity of early cervical cancer screening,and it is of great significance for the early prevention and treatment of cervical cancer.

关 键 词：宫颈癌 阴道镜活组织检验 液基脱落细胞学检查 人乳头状瘤病毒 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]