阴道镜阴性象限活检结合高危HPV mRNA诊断宫颈癌的价值  

Value of colposcopy negative quadrant biopsy combined with high-risk HPV mRNA in diagnosis of cervical cancer

作　　者：李锦花 梁晓燕[2] 刘银凤[1] Li Jinhua;Lang Kiooyun;Lis Yingfeng(Drpartment of obseries and Gnmcology,Taiyuan Peoples Hospial,Tairuan Shanxi 030006,P.R.China;Deportment of Pauhology,Taiyuan Peoples Hospial,Tairuan Shanxi 030006,P.R.China)

机构地区：[1]太原市人民医院妇产科,山西太原030006 [2]太原市人民医院病理科,山西太原030006

出　　处：《中国计划生育和妇产科》2024年第4期37-40,46,F0003,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：太原市科学技术研究与开发项目(项目编号:[2020]143号)。

摘　　要：目的探讨阴道镜阴性象限活检结合高危HPV mRNA诊断宫颈癌的价值,并分析其与病理诊断的一致性。方法选取2020年10月至2022年10月太原市人民医院122例疑似宫颈癌患者为研究对象,所有患者均接受阴道镜阴性象限活检与高危HPV mRNA检查,以组织病理诊断为金标准,探讨其诊断宫颈癌的意义。结果经组织病理检查结果显示,122例疑似宫颈癌患者中阳性98例(80.33%),其中低度鳞状上皮内病变31例,高度鳞状上皮内病变41例,鳞状细胞癌26例;阴性24例(19.67%);以组织病理检查结果为金标准,阴道镜阴性象限活检与高危HPV mRNA联合诊断宫颈癌的灵敏度高于单独检查(P<0.05);绘制受试者工作曲线(ROC)结果显示,阴道镜阴性象限活检、高危HPV mRNA单独诊断宫颈癌的AUC=0.726、0.710,具有一定诊断价值,但联合诊断价值更高(AUC=0.818);阴道镜阴性象限活检、高危HPV mRNA单独诊断宫颈病变类型与病理检查的一致性理想(Kappa=0.719、0.658,P均<0.05),阴道镜阴性象限活检结合高危HPV mRNA诊断宫颈病变类型与组织病理检查的一致性较好(Kappa=0.797,P<0.05)。结论阴道镜阴性象限活检结合高危HPV mRNA对宫颈癌具有较高诊断价值,有助于发现更多宫颈病变,可作为宫颈癌筛查的有效手段。Objective To explore the value of colposcopy negative quadrant biopsy combined with high-risk HPV mRNA in the diagnosis of cervical cancer,and analyze its consistency with pathological diagnosis.Methods A total of 122 patients with suspected cervical cancer in Taiyuan Peoples Hospital from October 2020 to October 2022 were included.All patients underwent colposcopy negative quadrant biopsy and high-risk HPV mRNA examination.Taking histopathological diagnosis as the gold standard,to explore its significance in the diagnosis of cervical cancer.Results Histopathological examination showed that 98 cases(80.33%)were positive in 122 suspected cervical cancer patients,including 31 cases of low-grade squamous intraepithelial lesions,41 cases of high-grade squamous intraepithelial lesions and 26 cases of squamous cell carcinoma,24 cases were negative(19.67%);taking histopathological examination results as the gold standard,the sensitivity of colposcopy negative quadrant biopsy combined with high-risk HPV mRNA in the diagnosis of cervical cancer was higher than that of single examination(P<0.05).The receiver's operating characteristic curve(ROC)showed that the AUC of colposcopy negative quadrant biopsy and high-risk HPV mRNA examination in the diagnosis of cervical cancer alone were 0.726 and 0.710,which had certain diagnostic value,but the combined diagnostic value was higher(AUC=0.818).The consistency between colposcopy negative quadrant biopsy and high-risk HPV mRNA alone with pathological examination in diagnosing cervical lesions was ideal(Kappa=0.719,0.658,P<0.05),and the consistency between colposcopy negative quadrant biopsy combined with high-risk HPV mRNA and histopathological examination in diagnosing cervical lesions was excellent(Kappa=0.797,P<0.05).Conclusion Colposcopy negative quadrant biopsy combined with high-risk HPV mRNA has high diagnostic value for cervical cancer,which is helpful to find more cervical lesions and can be used as an effective means for cervical cancer screening.

关 键 词：宫颈癌 阴道镜阴性象限活检 高危人乳头瘤病毒mRNA 病理诊断 

分 类 号：R737.33[医药卫生—肿瘤]