FH检测和TCT检查在宫颈病变筛查中的临床评价  

Clinical evaluation of FH test and TCT test in cervical lesion screening

作　　者：李微微 林艳华 黄梅秀 谢芳 陈惠妹 LI Weiwei;LIN Yanhua;HUANG Meixiu;XIE Fang;CHEN Huimei(Department of Obstetrics and Gynecology,Mindong Hospital Affiliated to Fujian Medical University,Fujian,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院妇产科,福建福安355000

出　　处：《中国医药科学》2020年第16期67-70,共4页China Medicine And Pharmacy

基　　金：福建省宁德市医药卫生类科技计划项目(20150058)。

摘　　要：目的探讨子宫上皮细胞稳定性检测(FH)和宫颈液基细胞学检查(TCT)在宫颈病变筛查中的临床应用价值。方法选取2015年6月~2018年6月在我院妇科宫颈疾病门诊就诊,行TCT检查并符合阴道镜转诊标准行宫颈活检的571例宫颈病变筛查患者为研究对象,阴道镜检查前进行FH检测,以组织病理学诊断结果作为金标准,比较FH检测与TCT检查对宫颈病变的检测能力。结果FH检出阳性352例(78.4%),TCT检出阳性375例(83.5%),两种方法检出阳性率比较差异无统计学意义(P>0.05)。在炎症、LSIL、HSIL和宫颈癌各病理分级病变中,TCT的阳性率均大于FH的阳性率,仅在宫颈炎症病变中,两种检测方法的阳性率差异有统计学意义(P<0.05)。随着病变级别的逐渐加重,FH与TCT检测的阳性率逐渐升高,且均与宫颈病变的进展相关。两种检测方法的敏感度、阳性预测值、阴性预测值、准确度差异均无统计学意义(P>0.05),但两种检测方法在特异度方面差异有统计学意义(P<0.05),FH检测的特异度优于TCT检查。结论FH检测的敏感度、特异度、阳性预测值、阴性预测值以及准确度与TCT检查相比差异较小,FH检测是一种新的宫颈病变筛查方法,具有检测简便、快速的优点,适用于基层临床医生初步快速评估女性的宫颈情况,具有一定的临床应用价值。Objective To explore the clinical application value of uterine epithelial cells stability FH test and thincytologic test(TCT)in cervical lesion screening.Methods 571 patients who underwent cervical lesion screening and TCT examination in gynecological cervical disease clinic of our hospital from June 2015 to June 2018 and met colposcopy referral criteria for cervical biopsy were selected as the research subjects.FH test was performed before colposcopy and histopathological diagnosis was used as the gold standard to compare the detection ability of FH test and TCT test for cervical lesions.Results 352 cases(78.4%)were detected as positive by FH and 375 cases(83.5%)were detected as positive by TCT,and there was no statistically significant difference in the positive rates between the two methods(P>0.05).The positive rate of TCT in the inflammation,low-grade squamous intraepithelial lesion(LSIL),high-grade squamous intraepithelial lesion(HSIL)and pathological grades of cervical cancer was greater than that of FH.Only in cervical inflammatory lesions,the difference in the positive rates between the two detection methods was statistically significant(P<0.05).With the gradual aggravation of the lesions,the positive rate of FH and TCT tests gradually increased,and both were related to the progression of cervical lesions.There was no statistical difference in sensitivity,positive predictive value,negative predictive value and accuracy between the two detection methods(P>0.05),but the specificity of FH test was better than that of TCT test,and the difference was statistically significant(P<0.05).Conclusion The sensitivity,specificity,positiv e predictive value,negative predictive value and accuracy of FH test are slightly different from those of TCT test.FH test is a new method for cervical lesion screening,which is simple and fast.It is suitable for primary clinicians to quickly evaluate female cervix and has certain clinical application value.

关 键 词：子宫上皮细胞稳定性FH检测 宫颈液基细胞学检查 宫颈病变 敏感度 特异度 

分 类 号：R711.74[医药卫生—妇产科学]