宫颈脱落细胞特殊染色技术在宫颈病变筛查中的应用价值  

Application value of the special staining technique of the cervical exfoliated cells for screening the cervical lesions

作　　者：王敏 李敏 王宁 刘玉珍 曹成成 张海凤 WANG Min;LI Min;WANG Ning;LIU Yuzhen;CAO Chengcheng;ZHANG Haifeng(School of clinical medicine,Shandong Second Medical University,Weifang,Shandong Province,261042;Affiliated Hospital of Shandong Second Medical University;National Research Institute for Family Planning;Weifang Peoples Hospital)

机构地区：[1]山东第二医科大学临床医学院,维坊261042 [2]山东第二医科大学附属医院 [3]国家卫生健康委科学技术研究所 [4]山东省潍坊市人民医院

出　　处：《中国计划生育学杂志》2024年第10期2340-2344,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨宫颈脱落细胞特殊染色技术在宫颈病变筛查中的临床应用价值。方法:选取2022年8月-2023年5月在山东第二医科大学附属医院及潍坊市人民医院进行宫颈病变筛查的女性共2000例,所有对象均进行宫颈脱落细胞特殊染色技术(FRD)检测、人乳头瘤病毒(HPV)和液基薄层细胞(TCT)检测。3种筛查方法任一结果阳性病例行阴道镜检查,阴道镜下有病变者行宫颈活检。以宫颈组织病理结果为金标准,比较FRD、TCT、HPV、HPV+TCT组的检测效能及受试者工作特征曲线下面积(AUC)。结果:FRD检测灵敏度为83.8%、特异度为90.0%,Kappa值为0.618,AUC为0.869;TCT检测的灵敏度为65.1%、特异度为89.5%,Kappa值为0.485,AUC为0.773;HPV检测的灵敏度为94.6%、特异度为71.7%,Kappa值为0.387,AUC为0.832;HPV+TCT联合检测的灵敏度为98.9%、特异度为70.2%,Kappa值为0.391,AUC为0.846。结论:宫颈脱落细胞特殊染色试验用于宫颈病变筛查有较好的效果,可用于基层宫颈病变筛查。Objective:To explore the clinical application value of the special staining technique of the cervical exfoliated cells for screening the cervical lesions.Methods:A total of 2000 women who underwent cervical lesion screening in the hospital from August 2022 to May 2023 were selected in this study.All these women had undergone the detections of the cervical exfoliated cell special staining technology(FRD),human papillomavirus(HPV)and thinprep cytology test(TCT)for their cervical lesion screening,the colposcopy was performed on the women with the positive screening re sult of one of the three methods,and the cervical biopsy was performed in the women with the cervical lesions by col-poscopic examination.The detection efficacy and the area under the curve(AUC)of the receiver operating characteris-tic curve were compared among the women with FRD detection,the women with TCT detection alone,the women with HPV detection alone and the women with TCT combined with HPV detections based on the histopathological findings as the gold standard of the cervical lesion.Results:The sensitivity,the specificity,the Kappa value and the.AUC of the FRD detection for the cervical lesions were 83.8%,90.0%,0.618 and 0.869,respectively.The sensitivity,the specificity,the Kappa value and the AUC of the TCT detection alone for the cervical lesions were 65.1%,89.5%,.0.485 and 0.773,respectively.The sensitivity,the specificity,the Kappa value of the HPV detection alone for the cer-vical lesions were 94.6%,71.7%,0.387 and 0.832,respectively.The sensitivity,the specificity,the Kappa value and the AUC of the TCT combined with HPV detections for the cervical lesions were 98.9%,70.2%,0.391 and 0.846,re-spectively.Conclusion:The special staining technique of the cervical exfoliated cells for screening the cervical lesions has better effective,and which can be used to cervical lesion screening in the grassroots level of the medical institu-tions.

关 键 词：宫颈癌筛查 宫颈脱落细胞特殊染色技术 液基薄层细胞检测 人乳头瘤病毒检测 

分 类 号：R711.74[医药卫生—妇产科学]