TCT与HPV E6蛋白筛查对宫颈癌及癌前病变的临床价值  

Clinical value of TCT and HPV E6 protein screening for cervical cancer and cervical intraepithelial neoplasia

作　　者：张娟[1] 康燕华[1] 谢双双 ZHANG Juan;KANG Yanhua;XIE Shuangshuang(Department of Gynecology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China,075000)

机构地区：[1]河北北方学院附属第一医院妇科,河北张家口075000

出　　处：《分子诊断与治疗杂志》2021年第12期1947-1950,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生厅科研基金项目(20190803)。

摘　　要：目的探讨TCT与HPV 161845型E6蛋白检测筛查对宫颈癌及癌前病变患者的临床价值。方法选取2019年3月至2021年3月于河北北方学院附属第一医院进行宫颈病变筛查的124例怀疑宫颈出现异常情况的受检者,均接受TCT及HPV 161845型E6蛋白检测筛查,以病理活检结果为金标准,比较TCT及HPV 161845型E6蛋白检测筛查单独检测及联合检测对于宫颈癌筛查的临床价值。结果受检者中正常及慢性炎症占比最大(57.26%),与检出CINⅠ级、CINⅡ级、CINⅢ级以及鳞状细胞癌占比比较差异有统计学意义(P<0.05)。TCT检出阳性符合率为78.18%,E6蛋白检出阳性符合率为82.35%,联合检出阳性符合率为95.92%,差异有统计学意义(P<0.05)。TCT、E6蛋白联合检测阳性结果中CINⅠ级29例,CINⅡ级11例,CINⅢ级5例,鳞状细胞癌2例。以活检诊断结果为金标准,采用TCT、E6蛋白联合检测诊断宫颈癌的Kappa值为0.866(P<0.05)。结论 TCT与HPV 161845型E6蛋白检测联合筛查宫颈癌及癌前病变可以提高检测敏感性、特异性以及检测准确性,联合检测可有效提高宫颈癌及癌前病变检出率。Objective To explore the clinical value of Thinprep cytologic test(TCT) and screening HPV 161845 E6 protein in patients with cervical cancer and cervical intraepithelial neoplasia(CIN).Methods A total of 124 patients with abnormal cervical status undergoing cervical lesion screening at the First Affiliated Hospital of Hebei North University were enrolled from March 2019 to March 2021. All underwent TCT and screening of HPV 161845 E6 protein. The pathological biopsy was used as the golden standard,the clinical value of TCT,HPV 161845 E6 protein screening and their combination for cervical cancer screening was compared. Results The proportion of normal and chronic inflammation was the largest(57.26%)among the subjects,which was significantly different from the proportions of CINⅠ,CINⅡ,CINⅢ,and squamous cell carcinoma(P<0.05). The positive coincidence rates of TCT,E6 protein and their combination were78.18%,82.35% and 95.92%(P<0.05). TCT and E6 protein combined detection showed positive results in 29 cases of CIN grade Ⅰ,11 cases of CIN grade Ⅱ,5 cases of CIN grade Ⅲ,and 2 cases of squamous cell carcinoma. Taking the results of biopsy diagnosis as the golden standard,Kappa value of TCT combined with E6 protein in the diagnosis of cervical cancer was 0.866(P<0.05). Conclusion TCT combined with HPV161845 E6 protein screening can improve the sensitivity,specificity and accuracy in the diagnosis of cervicalcancer and CIN,and the combined detection can effectively increase the detection rate of cervical cancer and CIN.

关 键 词：基薄层细胞检测 人乳头瘤病毒161845型E6蛋白检测 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]