TCT联合HR-HPV检测在宫颈癌及癌前病变早期筛查中的应用价值  

Application value of TCT combined with HR-HPV detection in early screening of cervical cancer and precancerous lesions

作　　者：宋谦 赵淑珍 茅夏铭 SONG Qian;ZHAO Shuzhen;MAO Xiaming(Urumqi Traditional Chinese Medicine Hospital,Urumqi,830000,China)

机构地区：[1]乌鲁木齐市中医医院,乌鲁木齐830000

出　　处：《新疆医学》2024年第4期420-422,426,共4页Xinjiang Medical Journal

摘　　要：目的探讨在宫颈癌及癌前病变早期筛查中选择液基薄层细胞检测(TCT)联合高危型人乳头状瘤病毒(HRHPV)检测的实际价值及有效性。方法选择2000例行宫颈癌及癌前病变早期筛查的患者,研究对象均取自2020年1月-2023年1月。均行TCT、HR-HPV检查。诊断金标准以病理结果为依据,对比TCT、HR-HPV单项及联合检测与病理结果的一致性。结果病理检查结果显示,2000例患者中,阳性共396例,阴性共1604例。TCT+HR-HPV联合检测的灵敏度94.41%、特异性98.50%及准确率98.80%均明显高于TCT单项检测80.00%、87.83%、86.95%、HR-HPV单项检测82.10%、94.81%、92.40%,具统计学意义(P<0.05)。TCT+HR-HPV检查的阳性、阴性预测值93.93%、98.62%明显高于TCT单项检测45.45%、97.19%和HR-HPV单项检测78.78%、95.76%,误诊率、漏诊率5.58%、1.51%明显低于TCT单项检测20.00%、12.17%和HR-HPV单项检测17.89%、5.18%,具统计学意义(P<0.05)。结论通过TCT+HR-HPV检测进行宫颈癌及癌前病变早期筛查,可显著提升诊断准确率,有助于临床早期诊治,提升诊疗质量,且对患者生存周期具有延长作用。Objective To explore the practical value and effectiveness of liquid-based thin-layer cell test(TCT)combined with high-risk human papillomavirus(HR-HPV)detection in the early screening of cervical cancer and precancerous lesions.Methods 2000 patients with cervical cancer and precancerous lesions were selected for early screening from January 2020 to January 2023.TCT and HR-HPV were performed.The diagnostic gold standard was based on the pathological results,and the consistency between the single and combined detection of TCT and HR-HPV and the pathological results was compared.Results Pathological examination showed among 2000 patients,396 cases were positive and 1604 cases were negative.For TCT+HR-HPV combined detection method,its sensitivity was 94.41%,its specificity was 98.50% and its accuracy was 98.80%.All data were significantly higher than those of TCT single detection which was 80.00%,87.83% and 86.95% respectively,and those of HR-HPV single detection which was 82.10%,94.81% and 92.40% respectively,and the difference was statistically significant(P<0.05).The positive and negative predictive values of TCT+HR-HPV were 93.93% and 98.62%,which were significantly higher than those of TCT single detection which was 45.45%,97.19% and those of HR-HPV single detection which was 78.78% and 95.76%.The misdiagnosis rate and missed diagnosis rate were 5.58% and 1.51% which were significantly lower than those of TCT single detection being 20.00% and 12.17%,and those of HR-HPV single detection which was 17.89% and 5.18%,and the difference was statistically significant(P<0.05).Conclusion Early screening of cervical cancer and precancerous lesions by TCT+HR-HPV detection can significantly improve the accuracy of diagnosis,contribute to early clinical diagnosis and treatment,improve the quality of diagnosis and treatment,and prolong the survival period of patients.

关 键 词：TCT HR-HPV检测 宫颈癌 癌前病变 早期筛查 诊断准确率 

分 类 号：R737.33[医药卫生—肿瘤]