基于液基细胞学的hWAPL蛋白检验在高危型人乳头瘤病毒感染患者宫颈癌筛查中的价值研究  

Value of hWAPL protein test based on liquid-based cytology in cervical cancer screening in high-risk human papillomavirus infected patients

作　　者：秦杰[1] 张一娇 路晓琳 董有伟 段爱红[1] QIN Jie;ZHANG Yijiao;LU Xiaolin;DONG Youwei;DUAN Aihong(Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院,河北邯郸056001

出　　处：《陕西医学杂志》2025年第2期268-271,276,共5页Shaanxi Medical Journal

基　　金：河北省医学科学研究课题(20200467,20220174);河北省邯郸市科学技术研究与发展计划项目(1723208069-6)。

摘　　要：目的:探讨基于液基细胞学的人半翼(hWAPL)蛋白检验在高危型人乳头瘤病毒(HR-HPV)感染患者宫颈癌筛查中的价值。方法:选取300例HPV感染女性为研究对象。采用杂交捕获技术进行常规HPV-DNA检测,阴道镜下取宫颈组织标本行组织病理学检查,并进行液基细胞学检查。采用免疫细胞化学技术检测液基细胞hWAPL蛋白表达。采用Kappa检验分析单独液基细胞学检查、液基细胞hWAPL蛋白检测与组织病理学检查结果的一致性,并比较单独液基细胞学检查和液基细胞hWAPL蛋白检测对HR-HPV感染患者宫颈癌的筛查效能。结果:300例宫颈液基细胞学标本中,共检测到18种HR-HPV亚型和5种低危型HPV亚型,其中HR-HPV感染患者236例,感染率为78.67%。组织病理学检查结果显示,阳性64例,阳性率为27.12%。单独液基细胞学检查结果显示,50例患者为阳性,阳性率为21.19%,与组织病理学检查一致性较高(Kappa=0.655,P<0.05)。液基细胞hWAPL蛋白检测结果显示,58例患者为阳性,阳性率为24.58%,与组织病理学检查一致性极好(Kappa=0.890,P<0.05)。与单独液基细胞学检查比较,液基细胞hWAPL蛋白检测筛查宫颈癌的敏感度、准确率、阳性预测值、阴性预测值升高,漏诊率降低(均P<0.05)。结论:基于液基细胞学的hWAPL蛋白检验对HR-HPV感染患者宫颈癌的筛查效能较高。Objective:To explore the value of human wings apart-like(hWAPL)protein testing based on liquid-based cytology in cervical cancer screening for patients with high-risk human papillomavirus(HR-HPV)infection.Methods:A total of 300 HPV-infected women were selected as the study subjects.Conventional HPV-DNA detection was performed using hybrid capture technology,cervical tissue specimens were taken under colposcopy for histopathological examination,and liquid-based cytology examination was conducted.Immunocytochemical technology was used to detect the expression of hWAPL protein in liquid-based cytology.Kappa test was used to analyze the consistency between individual liquid-based cytology examination,liquid-based cytology hWAPL protein testing and histopathological examination results,and to compare the screening efficacy of liquid-based cytology examination alone and liquid-based cytology hWAPL protein testing for cervical cancer in HR-HPV infected patients.Results:Among the 300 cervical liquid-based cytology specimens,a total of 18 HR-HPV subtypes and 5 low-risk HPV subtypes were detected,with 236 HR-HPV infected patients and an infection rate of 78.67%.Histopathological examination results showed that 64 cases were positive,with a positive rate of 27.12%.The results of individual liquid-based cytology examination showed that 50 patients were positive,with a positive rate of 21.19%,and the consistency with histopathological examination was high(Kappa=0.655,P<0.05).The results of liquid-based cytology hWAPL protein testing showed that 58 patients were positive,with a positive rate of 24.58%,and the consistency with histopathological examination was very good(Kappa=0.890,P<0.05).Compared with individual liquid-based cytology examination,the sensitivity,accuracy,positive predictive value,negative predictive value of liquid-based cytology hWAPL protein testing for cervical cancer screening were increased,and the missed diagnosis rate was reduced(all P<0.05).Conclusion:The hWAPL protein test based on liquid-based cytolo

关 键 词：宫颈癌 人半翼蛋白 人乳头瘤病毒 液基细胞学 组织病理学 筛查效能 

分 类 号：R737.33[医药卫生—肿瘤]