阴道镜检查联合HPV L1壳蛋白、p16蛋白检测筛查宫颈上皮内瘤变效果  

Effect of colposcopy combined with human papillomavirus Ll capsid protein and pl6 protein detections of women for screening their cervical intraepithelial neoplasia

作　　者：王颖 陈飞 苏展 贺竞 苏晓兰 WANG Ying;CHEN Fei;SU Zhan;HE Jing;SU Xiaolan(West China Guangan Hospital,Sichuan University,Guangan,Sichuan Province,638000)

机构地区：[1]四川大学华西广安医院,638000

出　　处：《中国计划生育学杂志》2024年第10期2415-2418,2464,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨宫颈病变筛查中阴道镜检查、人乳头瘤病毒L1(HPV L1)壳蛋白检测、多肿瘤抑制基因(MTS1,p16蛋白)检测和联合诊断在宫颈上皮内瘤变(CIN)的临床应用效果。方法:收集2022年6月-2023年6月本院妇科门诊因疑存宫颈病变进行宫颈癌筛查的女性201例,均行HPV L1壳蛋白、p16蛋白检测和阴道镜检查,以阴道镜下宫颈组织活检病理结果为诊断依据,对HPV L1壳蛋白、p16蛋白检测、阴道镜检查及3项联合诊断的效果进行分析。结果:宫颈病理诊断无病变121例,病变80例(CIN1级54例、CIN2级25例、CIN3级1例)。阴道镜CIN检出率为53.7%,灵敏度81.3%,特异度64.5%,准确度为71.1%;HPV L1壳蛋白检测CIN检出率为55.2%,灵敏度73.8%,特异度为57.0%,精确度为63.7%。p16蛋白检测CIN检出率为53.7%,灵敏度83.8%,特异度66.1%,精确度73.1%。3项联合检测CIN检出率为64.2%,灵敏度97.5%,特异度57.9%,精确度74.6%。筛查灵敏度阴道镜、HPV L1壳蛋白、p16蛋白检测无差异(χ^(2)=2.667,P>0.05),但3项联合诊断的灵敏度高于各单独指标检测(χ^(2)=11.123、18.331、8.901,P<0.05),特异度3项联合诊断与单独指标无差异(χ^(2)=3.233,P>0.05)。结论:阴道镜检查联合HPV L1壳蛋白,p16蛋白检测筛查CIN的灵敏度可显著提高,可为临床提供有价值的诊断证据。Objective:To explore the clinical application effect of cervical lesion screening methods of colposcopy,human papillomavirus(HPV)L1 capsid protein detection and p16 protein detection of women for screening their cervical intraepithelial neoplasia(CIN).Methods:201 women who received cervical cancer screening due to the suspected cervical lesions in gynecological clinic of the hospital were selected in this study from June 2022 to June 2023.The detections of HPV L1 capsid protein and p16 protein,and the colposcopy examination of these women were performed to diagnose their CIN.The effect of HPV L1 capsid protein detection,p16 protein detection,colposcopy and the combined of HPV L1 capsid protein and p16 protein detection,and colposcopy of the patients for diagnosing their CIN was analyzed based on the colposcopic cervical tissue biopsy as the diagnostic standard.Results:There were 121 women without cervical lesions,and 80 women with cervical lesions based on the colposcopic cervical tissue biopsy,including 54 cases with CINⅠ,25 cases with CINⅡand 1 case with CINⅢ.The detection rate,the sensitivity,the specificity,and the accuracy of the colposcopy for screening CIN of the women were 53.7%,81.3%,64.5%and 71.1%,respectively,which of the HPV L1 capsid protein level for screening CIN were 55.2%,73.8%,57.0%and 63.7%,respectively,and which of the p16 protein level for screening CIN were 53.7%,83.8%,66.1%and 73.1%,respectively.The sensitivity,the specificity and the accuracy of the combined the colposcopic examination and the detections of the HPV L1 capsid protein and p16 protein levels of the women for screening their CIN were 97.5%,57.9%and 74.6%,respectively.There was no significant difference in the sensitivity of the women for screening their CIN among the colposcopy,the HPV L1capsid protein detection and p16protein detection(χ^(2)=2.667,P>0.05).The sensitivity of the combined colposcopy examination and the detections of the HPV L1 capsid protein and p16protein of the women for screening their CIN was signifi

关 键 词：宫颈上皮内瘤变 阴道镜 HPV L1壳蛋白 P16蛋白 灵敏度 

分 类 号：R737.33[医药卫生—肿瘤]