人乳头瘤病毒基因分型联合TCT检测在早期宫颈癌筛查中的应用价值探讨  

Application Value of Human Papillomavirus Genotyping Combined with TCT in Early Screening for Cervical Cancer

作　　者：韩晓宇[1] 张力丹[1] 李淼[1] 乔海芝 HAN Xiaoyu;ZHANG Lidan;LI Miao;QIAO Haizhi(Baoding No.1 Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院,保定071000

出　　处：《病毒学报》2024年第4期843-849,共7页Chinese Journal of Virology

摘　　要：为了探讨人乳头瘤病毒(Human papillomavirus,HPV)基因分型检测联合液基薄层细胞学检测(Thin⁃prep cytologic test,TCT)在早期宫颈癌筛查中的应用价值,本研究选取2020年3月至2023年9月于我院妇科门诊行宫颈癌筛查的176例患者,所有患者均进行HPV基因分型检测、TCT检测以及阴道镜下宫颈组织病理学检测,并以病理学检测结果作为“金标准”,分析HPV基因分型、TCT检测以及二者联合检测宫颈病变及宫颈癌的诊断符合率,采用受试者工作特征(ROC)曲线下面积对二者单独检测及联合检测在早期宫颈癌筛查中的诊断价值进行评估。结果发现,176例行宫颈癌筛查患者中共检测出HPV感染者47例(26.70%),HPV感染基因分型中排列前五位的亚型依次为HPV 16、HPV 58、HPV52、HPV 18和HPV 11;与病理检测诊断相比,HPV基因检测诊断的符合率为76.92%(10/13);TCT检测宫颈癌前病变及宫颈癌的诊断符合率为53.85%(7/13)。检测结果显示,TCT与HPV基因单独检测的诊断符合率均低于HPV与TCT联合检测的诊断符合率,其中TCT检测与联合检测的诊断符合率对比差异具有统计学意义(P<0.05)。HPV与TCT联合检测的诊断灵敏度均高于二者单一检测,其中联合检测的诊断灵敏度较TCT检测更为显著(P<0.05)。ROC曲线显示,联合检测的AUC高于HPV和TCT单一检测(P<0.05)。本研究结果表明,HPV基因分型检测联合TCT检测在早期宫颈癌筛查中与病理学检测的诊断率相符,二者联合检测的诊断符合率高于单独检测,且联合检测能够进一步提高宫颈病变的诊断效能。We wished to investigate human papillomavirus(HPV)genotyping combined with the Thin⁃prep cytologic test(TCT)to ascertain the application value of TCT in early screening for cervical cancer(CC).A total of 176 patients who underwent CC screening in the gynecological outpatient department of our hospital from March 2020 to September 2023 were enrolled.All patients underwent HPV genotyping detection,TCT detection,and colposcopic cervical histopathology.Pathological test results were used as the“gold standard”to analyze the diagnostic coincidence of HPV genotyping,TCT detection,as well as the combined detection of cervical lesions and CC.The diagnostic value of the two tests alone and combined detection in early screening for CC was evaluated using the area under the receiver operating characteristics(ROC)curve(AUC).Forty⁃seven(26.70%)cases of HPV infection were detected in 176 patients who underwent CC screening.The top⁃five subtypes of HPV infection were HPV 16,HPV 58,HPV52,HPV 18 and HPV 11.The coincidence of HPV gene detection was 76.92%(10/13)compared with pathological detection.The diagnostic coincidence of TCT for cervical precancerous lesions and CC was 53.85%(7/13).These results showed that the diagnostic coincidence of TCT alone and HPV gene detection alone was lower than that of combined detection using HPV and TCT.The difference between the diagnostic coincidence of TCT and combined detection was significant(P<0.05).The diagnostic sensitivity of combined detection of HPV and TCT was higher than that of single detection,and the diagnostic sensitivity of combined detection was more significant than that of TCT detection(P<0.05).The AUC of the combined test was higher than that of the HPV test alone and TCT test alone(P<0.05).Overall,we showed that the diagnostic success of HPV genotyping combined with TCT detection was consistent with that of pathology detection in early screening for CC.The diagnostic coincidence of combined detection was higher than that of single detection.Combined detection cou

关 键 词：人乳头瘤病毒基因分型 液基薄层细胞学 联合检测 早期宫颈癌筛查 应用价值 

分 类 号：R373.9[医药卫生—病原生物学]