液基薄层细胞学检查联合高危人乳头瘤病毒检测在育龄期女性宫颈疾病筛查中的临床价值  

The clinical value of liquid based thin layer cytology combined with high-risk human papilloma virus detection in screening cervical diseases in women of childbearing age

作　　者：胡培章 陈黎明 李青梅 HU Peizhang;CHEN Liming;LI Qingmei(Department of Laboratory,Guixi People's Hospital,Yingtan,Jiangxi,335400,China;The Second Department of External Medicine,Guixi Hospital of Traditional Chinese Medicine,Yingtan,Jiangxi,335400,China)

机构地区：[1]贵溪市人民医院检验科,江西鹰潭335400 [2]贵溪市中医院外二科,江西鹰潭335400

出　　处：《当代医学》2023年第12期68-71,共4页Contemporary Medicine

摘　　要：目的分析液基薄层细胞学检查(TCT)联合高危人乳头瘤病毒(HPV)检测在育龄期女性宫颈疾病筛查中的应用价值。方法回顾性分析2018年2月至2020年2月于贵溪市人民医院诊治的188例宫颈病变患者的临床资料,所有患者均进行TCT、高危HPV检测和病理检查。以病理检查结果为金标准,分析高危HPV、TCT和高危HPV联合TCT符合情况及高危HPV联合TCT对宫颈癌(CC)的诊断价值。结果阴道镜宫颈活检病理共检出炎症/正常128例,CINⅠ级31例,CINⅡ级11例,CINⅢ级18例,高危HPV检查中CINⅠ符合率最高,为74.19%,其中CINⅠ误诊率为9.68%,CINⅡ误诊率为45.45%,CINⅢ误诊率为11.11%。TCT检查中CINⅠ符合率最高,为80.65%,其中CINⅠ误诊率为6.46%,CINⅡ误诊率为27.27%,CINⅢ误诊率为11.11%。高危HPV、TCT、高危HPV联合TCT检查特异度比较差异无统计学意义,灵敏度、阴性预测值、阳性预测值比较差异有统计学意义(P<0.05)。高危HPV联合TCT诊断灵敏度、阴性预测值高于高危HPV、TCT检查,阳性预测值高于高危HPV检查,差异有统计学意义(P<0.05);其他指标两两比较差异无统计学意义。结论TCT联合高危HPV用于筛查育龄期女性宫颈疾病价值较高,能提升筛查准确率,值得临床推广应用。Objective To analyze the application value of liquid based thin layer cytology(TCT)combined with high-risk human papillomavirus(HPV)detection in screening cervical diseases in women of childbearing age.Methods The clinical data of 188 patients with cervical lesions diagnosed and treated in Guixi People's Hospital from February 2018 to February 2020 were retrospectively analyzed.All patients underwent TCT,highrisk HPV detection and Pathological examination.Pathological examination results were used as the gold standard to analyze the diagnostic value of high-risk HPV,TCT and high risk HPV combined with TCT for cervical cancer(CC).Results A total of 128 cases of inflammation/normal,31 cases of CINⅠgrade,11 cases of CINⅡgrade,18 cases of CINⅢgrade were detected by colposcopic cervical biopsy.The CINⅠcompliance rate was the highest among high-risk HPV tests,which was 74.19%.The misdiagnosis rate of CINⅠ,CINⅡand CINⅢwas 9.68%,45.45%and 11.11%respectively.In TCT examination,the conformity rate of CINⅠwas the highest(80.65%),and the misdiagnosis rate of CINⅠwas 6.46%,CINⅡwas 27.27%,and CINⅢwas 11.11%.There was no significant difference in the specificity of high-risk HPV,TCT,and high-risk HPV combined with TCT,there were significant differences in sensitivity,negative predictive value and positive predictive value(P<0.05).The diagnostic sensitivity of high-risk HPV combined with TCT,negative predictive value were higher than those of high-risk HPV and TCT,and the positive predictive value was higher than that of high-risk HPV,the differences were statistically significant(P<0.05).Other pairwise comparisons were not statistically significant.Conclusion TCT combined with high-risk HPV for screening cervical diseases in women of childbearing age has high value,can improve screening accuracy,and is worthy of clinical promotion and application.

关 键 词：液基薄层细胞学检查 高危人乳头瘤病毒 筛查 育龄期 女性 宫颈疾病 

分 类 号：R737.33[医药卫生—肿瘤]