HPV E6/E7、宫颈液基细胞学、阴道镜联合检查在宫颈癌筛查中的价值分析  

Value of combined HPV E6/E7,cervical liquid-based cytology and colposcopy in the screening of cervical cancer

作　　者：鲍双双 朱献斐[1] 唐咏梅[1] BAO Shuangshuang;ZHU Xianfei;TANG Yongmei(Department of Pathology,Yiwu Central Hospital,Yiwu 322000,Zhejiang,China)

机构地区：[1]义乌市中心医院病理科,浙江义乌322000

出　　处：《中国现代医生》2023年第20期14-17,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY753)。

摘　　要：目的探究高危型人乳头瘤病毒(human papilloma virus,HPV)E6/E7、宫颈液基细胞学(thinprep cytologic test,TCT)、阴道镜检查对宫颈癌及癌前病变筛查价值的差异。方法选取2020年7月至2021年7月义乌市中心医院收治的均进行过HPV E6/E7 mRNA、TCT及阴道镜检查的宫颈异常患者753例,以活检组织病理结果为金标准,分析不同检查方法对宫颈癌及癌前病变的筛查价值。结果活检组织病理学检测结果显示,753例病例中有低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)532例,高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)203例,鳞状细胞癌(squamous cell carcinoma,SCC)18例;HPV E6/E7检出阳性407例,TCT检出阳性288例,阴道镜检查阳性206例;HPV E6/E7、TCT检查的诊断一致性为62.42%;与联合检测比较,HPV E6/E7、TCT及阴道镜检测HSIL+SCC的敏感度、特异性、准确性均较低,差异均有统计学意义(P<0.05)。结论HPV E6/E7、TCT、阴道镜三者联合检测可提高对宫颈癌的筛查价值,可帮助临床更好地进行诊断与治疗。Objective To investigate the difference of screening value of high-risk human papilloma virus(HPV)E6/E7,thinprep cytologic test(TCT)and colposcopic biopsy for cervical cancer.Methods A total of 753 patients with cervical abnormalities who underwent HPVE6/E7 mRNA,TCT and colposcopic biopsy in Yiwu Central Hospital from July 2020 to July 2021 were selected.With the histopathological results as the gold standard,the screening value of different examination methods for cervical cancer was analyzed.Results Histopathological biopsies showed that there were 532 cases of low-grade squamous intraepithelial lesion(LSIL),203 cases of high-grade squamous intraepithelial lesion(HSIL)and 18 cases of squamous cell carcinoma(SCC)in 753 cases.HPV E6/E7 was detected in 407 cases,TCT in 288 cases and colposcopy in 206 cases;the diagnostic concordance of HPV E6/E7 and TCT was 62.42%,and the sensitivity,specificity and accuracy of HPV E6/E7,TCT and colposcopy in detecting HSIL+SCC were all lower compared with the combined test,and the differences were statistically significant(P<0.05).Conclusion The combination of HPV E6/E7,TCT and colposcopy can improve the value of screening for cervical cancer and may help in better clinical diagnosis and treatment.

关 键 词：高危型人乳头瘤病毒 宫颈液基细胞学 阴道镜检查 宫颈癌 

分 类 号：R361.3[医药卫生—病理学]