SCCA、HPV-DNA联合阴道镜检查在宫颈鳞状细胞癌筛查中的应用价值  

Application value of SCCA,HPV-DNA combined with colposcope in cervical squamous cell carcinoma screening

作　　者：梁锐根[1] 关燕鸣[1] 杨嘉泳 LIANG Ruigen;GUAN Yanming;YANG Jiayong(BOAI Hospital of Zhongshan,Zhongshan 528400,China)

机构地区：[1]中山市博爱医院,广东中山528400

出　　处：《广州医药》2023年第9期75-78,89,共5页Guangzhou Medical Journal

基　　金：中山市科技局立项(2022B1025)。

摘　　要：目的探讨鳞状上皮细胞抗原(SCCA)、人乳头瘤病毒(HPV)-DNA联合阴道镜检查在宫颈鳞状细胞癌(SCC)筛查中的应用价值。方法选择2019年1月1日-2021年12月31日在中山市博爱医院就诊并确诊为SCC的妇女作为研究对象,共纳入100例SCC患者(SCC组),同时选择200例经活检确诊为宫颈慢性炎症的患者(宫颈慢性炎症组)作为阴性对照。采用阴道镜观察研究对象的宫颈情况,并采集研究对象的宫颈组织标本进行HPV-DNA检测。采集研究对象的静脉血,采用化学发光免疫法测定研究对象SCCA的水平。以病理检查结果为金标准,分别对HPV-DNA检测、外周血SCCA两者联用以及阴道镜、HPV-DNA检测、外周血SCCA三者联用进行筛查效果的评价。结果SCC组研究对象的年龄≥40岁者、出血者、性生活开始年龄≤20岁者比例均高于宫颈慢性炎症患者组;而宫颈慢性炎症患者组疼痛的比例高于SCC患者组,差异均有统计学意义(P<0.01)。χ^(2)检验结果显示,SCC组研究对象的SCCA阳性率高于宫颈慢性炎症组(P<0.001)。阴道镜结合SCCA、HPV-DNA检测筛查SCC的灵敏度和特异度均高于单独使用SCCA和HPV-DNA,并取得较好的约登系数(75%)和Kappa值(0.730)。结论采用阴道镜结合HPV-DNA、SCCA可有效提高SCC疾病的约登系数与Kappa值,其联合诊断的效能高于单独使用阴道镜、HPV-DNA或SCCA诊断SCC。Objective To study the application value of squamus cell carcinoma antigen(SCCA)and human papillomavirus(HPV)-DNA combined with colposcope in cervical squamous cell carcinoma(SCC)screening.Methods Women diagnosed with SCC who visited Boai Hospital of Zhongshan city from January 1,2019 to December 31,2021 were selected as research subjects,including 100 patients with SCC(SCC group)and 200 patients with chronic cervical inflammation confirmed by biopsy(chronic cervical inflammation group).The cervix of the subjects was observed by colposcope,and cervical tissue samples were collected for HPV-DNA testing.Venous blood of subjects was collected and SCCA levels were determined by chemiluminescence immunoassay.Using pathological examination results as the gold standard,the screening effect of combination HPV-DNA test and peripheral blood SCCA test,combination colposcope,HPV-DNA test and peripheral blood SCCA were evaluated respectively.Results In SCC group,the proportion of age≥40 years old,bleeding,sexual life age≤20 years old were higher than those in chronic cervical inflammation group,but chronic cervical inflammation group had higher rate of pain than those in SCC group(P<0.01)by Chi-square test.SCCA positive rate in SCC group was higher than that in chronic cervical inflammation group(P<0.001)by Chi-square test.The sensitivity and specificity of colposcope combined with SCCA and HPV-DNA were higher than those of SCCA and HPV-DNA alone,and better Youden’s coefficient(75%)and Kappa value(0.730)were obtained.Conclusions Colposcope combined with HPV-DNA and SCCA can effectively improve the Youden’s coefficient and Kappa value of SCC disease,and its combined diagnosis efficiency was higher than that of colposcope,HPV-DNA and SCCA alone in the diagnosis of SCC,which has high clinical promotion significance.

关 键 词：鳞状上皮细胞抗原 人乳头瘤病毒-DNA 阴道镜 宫颈鳞状细胞癌 

分 类 号：R737.33[医药卫生—肿瘤]