SCC⁃Ag、HPV分型联合p53检测在宫颈癌早期筛查中的诊断效能  

Diagnostic efficacy of SCC⁃Ag,HPV typing combined with p53 test in early cervical cancer screening

作　　者：马海英 李媛媛 朱学芳[3] 纪燕 王丽娜 MA Haiying;LI Yuanyuan;ZHU Xuefang;JI Yan;WANG Lina(Department of Gynecology,Yangzhou Second People's Hospital,Yangzhou,Jiangsu,China,225002;Cervical clinic,Subei People's Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,China,225002;Department of Reproductive Health,Yangzhou Maternal and Child Health Care Hospital,Yangzhou,Jiangsu,China,225002;Department of Clinical Laboratory,Yangzhou Second People's Hospital,Yangzhou,Jiangsu,China,225002)

机构地区：[1]扬州市第二人民医院妇科,江苏扬州225002 [2]扬州大学附属苏北人民医院宫颈专病门诊,江苏扬州225002 [3]扬州市妇幼保健院生殖健康科,江苏扬州225002 [4]扬州市第二人民医院检验科,江苏扬州225002

出　　处：《分子诊断与治疗杂志》2024年第11期2016-2020,共5页Journal of Molecular Diagnostics and Therapy

基　　金：国家自然科学基金项目(82001512)。

摘　　要：目的分析鳞状细胞癌抗原(SCC⁃Ag)、HPV人乳头瘤病毒(HPV)分型联合血清p53抑癌基因检测在宫颈癌早期筛查中的诊断效能。方法选取扬州市第二人民医院2022年5月至2023年5月宫颈癌女性45例为宫颈癌组,选取宫颈良性肿瘤女性43例为宫颈良性肿瘤组,另选取同期本院体检中心健康体检志愿者42名为对照组,比较三组SCC⁃Ag、HPV分型及p53的检测结果;分析较宫颈癌组和宫颈良性肿瘤组HPV分型结果,以病理诊断为金标准,分析SCC⁃Ag、HPV分型及p53检测单一以及联合诊断宫颈癌的一致性;绘制ROC曲线,分析SCC⁃Ag、HPV分型、p53单一及联合检测对宫颈癌的诊断效能。结果宫颈癌组SCC⁃Ag水平高于宫颈良性肿瘤组、对照组,HPV分型、p53阳性表达例数多于宫颈良性肿瘤组、对照组,差异均有统计学意义(P<0.05);宫颈癌组高危亚型感染率高于宫颈良性肿瘤组,低危亚型低于宫颈良性肿瘤组,差异均有统计学意义(P<0.05);SCC⁃Ag、HPV分型及p53单一及联合筛查宫颈癌与病理学检查结果的一致性Kappa值分别为:0.767、0.729、0.712、0.932;ROC曲线显示,SCC⁃Ag+HPV分型+p53联合检测诊断宫颈癌的灵敏度、特异度、AUC分别为92.76%、87.28%、0.906,明显高于三者单一检测(P<0.05)。结论SCC⁃Ag、HPV分型联合p53检测的诊断效能高于三者单一检测,提示三者联合检测可显著提高宫颈癌早期筛查的诊断效能,可为制定临床治疗方案提供一定参考依据。Objective To analyze the diagnostic efficacy of squamous cell carcinoma antigen(SCC⁃Ag),HPV human papilloma virus(HPV)typing combined with serum p53 oncogene testing in the early screening of cervical cancer.Methods In this study,a retrospective method was used to select 45 women with cervical cancer from May 2022 to May 2023 at Yangzhou Second People's Hospital for the cervical cancer group.Additionally,43 women with cervical benign tumors were selected as the cervical benign tumor group,and 42 healthy volunteers from the physical examination center of our hospital during the same period were chosen as the control group.The SCC⁃Ag,HPV typing,and p53 detection results of the three groups were compared.The results of HPV typing in the cervical cancer group and cervical benign tumor group were analyzed.The consistency of SCC⁃Ag,HPV typing and p53 detection in single and combined diagnoses of cervical cancer was analyzed with pathological diagnosis as the gold standard.The ROC curve was drawn to analyze the diagnostic efficacy of SCC⁃Ag,HPV typing,p53 single and combined detection for cervical cancer.Results The SCC⁃Ag level in the cervical cancer group was higher than that in the cervical benign tumor group and the control group.Additionally,the number of cases with HPV typing and p53 positive expression was greater in the cervical cancer group compared to the cervical benign tumor group and the control group,with statistically significant differences(P<0.05).The infection rate of high⁃risk HPV subtypes in the cervical cancer group was also higher than that in the benign tumor group,while the infection rate of low⁃risk subtypes was lower in the cervical cancer group benign tumor group.These differences were statistically significant(P<0.05).The consistency Kappa values for SCC⁃Ag,HPV typing,and p53 single and combined screening in cervical cancer compared to pathological examination results were 0.767,0.729,0.712,and 0.932,respectively.The ROC curve indicated that the sensitivity,specificity,and AUC

关 键 词：SCC⁃Ag HPV分型 P53 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]