液基薄层细胞学检查联合HPV-DNA检查对宫颈疾病的诊断效能  

The Diagnostic Efficacy of Thin-Prepcytology Test Combined with HPV-DNA Detection for Cervical Diseases

作　　者：史永灿 SHI Yongcan(Pathology Department,Jinxiang County People’s Hospital,Jining 272200,Shandong Province,China)

机构地区：[1]金乡县人民医院病理科,山东济宁272200

出　　处：《中国实用乡村医生杂志》2024年第8期58-60,64,共4页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨液基薄层细胞学检查(thin-prepcytology test,TCT)联合人乳头瘤病毒(human papilloma virus,HPV)检查,对宫颈疾病的诊断效能。方法选择2020年1月—2023年12月在金乡县人民医院进行宫颈疾病检查的女性患者320例,全部患者均同时进行TCT和HPV-DNA检查。以阴道镜检查为金标准,比较联合检查与单独检查的诊断一致性和诊断效能。结果TCT诊断的Kappa=0.250,诊断一致性一般;HPV-DNA诊断的Kappa=0.423,诊断一致性中等;联合检查的Kappa=0.855,诊断一致性良好。联合检查的灵敏度为92.9%,高于TCT的61.7%和HPV-DNA的68.4%;联合检查的特异度为93.5%,高于TCT的64.5%和HPV-DNA的75.8%;联合检查的诊断符合率为93.1%,高于TCT的62.8%和HPV-DNA的71.3%;联合检查的阳性预测值为95.8%,高于TCT的73.3%和HPV-DNA的83.5%;联合检查的阴性预测值为89.2%,高于TCT的51.6%和HPVDNA的60.3的%,差异有统计学意义(P<0.05)。结论对于诊断女性宫颈疾病,TCT联合HPV-DNA检查相比于阴道镜检查,具有良好的一致性,而且联合检查的诊断效能优于单独检查。Objective To explore the diagnostic efficacy of thin-prepcytology test(TCT)combined with human papillomavirus(HPV)test for cervical diseases.Methods Three-hundred and twenty female patients who underwent cervical disease examinations at Jinxiang County People’s Hospital from January 2020 to December 2023 were selected,and all patients underwent TCT and HPV-DNA examinations simultaneously.Using colposcopy examination as the gold standard,diagnostic consistency and diagnostic efficacy of combined examination and individual examination were compared.Results The Kappa of TCT diagnosis was 0.250,with ordinary diagnostic consistency.The Kappa of HPV-DNA diagnosis was 0.423,with moderate diagnostic consistency.The Kappa of joint diagnosis was 0.855,with good diagnostic consistency.The sensitivity of joint diagnosis is 92.9%,which was higher than 61.7%of TCT and 68.4%of HPV-DNA.The specificity of combined diagnosis was 93.5%,which was higher than 64.5%of TCT and 75.8%of HPV-DNA.The diagnostic accuracy of joint diagnosis was 93.1%,which was higher than 62.8%of TCT and 71.3%of HPV-DNA.The positive predictive value of joint diagnosis was 95.8%,which was higher than 73.3%of TCT and 83.5%of HPV-DNA.The negative predictive value of combined diagnosis was 89.2%,which was higher than 51.6%of TCT and 60.3%of HPV-DNA(P<0.05).Conclusion For the diagnosis of cervical diseases in women,TCT combined with HPV-DNA examination has good consistency compared to colposcopy examination,and the diagnostic efficacy of the combined examination is better than that of individual examination.

关 键 词：液基细胞学检查 HPV-DNA检测 宫颈 筛查 诊断效能 

分 类 号：R446.8[医药卫生—诊断学]