高危型HPV检测联合TCT对宫颈癌前病变筛查的意义分析  

Analysis of the significance of high risk HPV detection combined with TCT in screening cervical precancerous lesions

作　　者：高顺梅 李鑫瀛 马英 Gao Shunmei;Li Xinying;Ma Ying(Department of Laboratory Medicine,Chongqing Wulong District People's Hospital,Chongqing 408500,China;Shengxiang Biotechnology Co.,LTD.,Changsha 410221,China;Department of Pathology,Chongqing Wulong District People's Hospital,Wulong 408500,China)

机构地区：[1]重庆市武隆区人民医院检验科,重庆武隆408500 [2]圣湘生物科技股份有限公司,湖南长沙410221 [3]重庆市武隆区人民医院病理科,重庆武隆408500

出　　处：《实用妇科内分泌电子杂志》2022年第21期87-90,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的 探讨高危型人乳头瘤病毒(HR-HPV)检测联合液基薄层细胞学检测(TCT)在宫颈癌前病变筛查中的应用价值。方法 选取于本院进行宫颈病变筛查的门诊、住院、体检女性共567例为研究对象,均进行HR-HPV、TCT检测及病理活检,以病理组织学诊断为金标准,对比HR-HPV、TCT单独检测及二者联合检测的诊断价值。结果 567例女性经病理检查确诊为宫颈癌前病变者共190例,阳性检出率为33.5%(190/567);HR-HPV检测阳性检出率为66.0%(374/567);TCT阳性检出率为51.0%(289/567);联合检测阳性检出率为28.9%(164/567)。联合检测灵敏度低于HRHPV及TCT单项检测,特异度、准确度、阳性预测值均高于HR-HPV及TCT单项检测,差异有统计学意义(P<0.05);联合检测阴性预测值与HR-HPV及TCT单项检测比较,差异无统计学意义(P>0.05)。kappa检验显示,HR-HPV检测与病理组织学检查一致性较差(kappa值=0.138,P<0.05);TCT与病理组织学检查一致性较差(kappa值=0.169,P<0.05);而联合检测与病理组织学检查一致性尚可(kappa值=0.336,P<0.05)。结论 HR-HPV检测联合TCT可提高宫颈癌前病变诊断的特异度、准确度及阳性预测值,可作为单项检测初筛的分流手段,能够在尽可能减少不必要检测的同时,及时发现宫颈癌前病变,便于临床尽早开展相应治疗,预防宫颈癌发生。Objective To investigate the application value of high risk human papillomavirus(HR-HPV) detection combined with thinprep cytologic test(TCT) in screening cervical precancerous lesions. Methods A total of 567 outpatient, inpatient and physical examination women who were screened for cervical lesions in our hospital were selected as subjects. Detection of HR-HPV and TCT and pathological biopsy were performed, and histopathological diagnosis was used as the gold standard. The diagnostic values of single detection and combined detection of HR-HPV and TCT were compared. Results 190 of the 567 women were diagnosed as precancerous lesions by pathological examination, and the positive detection rate was 33.5%(190/567);the positive rate of HR-HPV was 66.0%(374/567);the positive detection rate of TCT was 51.0%(289/567);and the positive detection rate of combined test was 28.9%(164/567). The sensitivity of combined test was lower than that of HR-HPV and TCT single test, and the specificity, accuracy and positive predictive value were higher than those of HR-HPV and TCT single test, the differencea were statistically significant(P<0.05);there was no significant difference in the negative predictive value between combined test and HR-HPV and TCT single test(P>0.05). Kappa test showed poor consistency between HR-HPV test and histopathological examination(kappa value=0.138, P<0.05);the consistency between TCT and histopathology was poor(kappa value=0.169, P<0.05);while the consistency between combined test and histopathological examination was satisfactory(kappa value=0.336, P<0.05). Conclusion HR-HPV detection combined with TCT can improve the specificity, accuracy and positive predictive value of the diagnosis of cervical precancerous lesions. It can be used as a shingle means for the preliminary screening of single detection, which can detect cervical precancerous lesions in time while reducing unnecessary detection as much as possible, so as to facilitate the early clinical treatment and prevent the occurrence of cervical

关 键 词：子宫颈癌前病变 人乳头瘤病毒 薄层液基细胞学检测 

分 类 号：R737.33[医药卫生—肿瘤]