不同筛查方法单独及联合应用对宫颈病变的诊断效能  

Diagnostic efficacy of different screening methods alone and in combination for cervical lesions

作　　者：沙畑畑 王玉茹 张跃明 冯君 SHA Tiantian;WANG Yuru;ZHANG Yueming;FENG Jun(Department of Gynaecology and Obstetrics,the Fourth Affiliated Hospital of Soochow University,Jiangsu Province,Suzhou 215000,China)

机构地区：[1]苏州大学附属第四医院妇产科,江苏苏州215000

出　　处：《中国当代医药》2025年第8期63-66,71,共5页China Modern Medicine

摘　　要：目的探讨液基薄层细胞学检测(TCT)、高危亚型人乳头瘤病毒(HPV)病毒株筛查、细胞DNA定量分析单独及联合筛查宫颈高级别鳞状上皮内病变(HSIL)及宫颈癌(CC)的诊断效能,为进一步完善宫颈癌防治策略提供依据。方法选取2020年12月至2022年11月就诊于苏州大学附属第四医院的662例行阴道镜检查有明确病理结果的患者为研究对象,采用回顾性研究方法,比较分析TCT、HPV筛查、细胞DNA定量分析3种方法单独及联合筛查的敏感度和特异度。结果单项筛查中敏感度从高到低分别是细胞DNA定量分析(88.9%),HPV筛查(84.8%),TCT(46.8%),特异度从高到低分别是TCT(94.4%),细胞DNA定量分析(88.1%),HPV筛查(20.8%),而联合筛查中TCT联合HPV筛查并联筛查敏感性最高(98%),TCT联合HPV筛查串联特异度最高(97.2%),综合对比后细胞DNA定量分析(敏感度为88.9%,特异度为88.1%)和细胞DNA定量分析并联TCT的方式(敏感度为88.9%,特异度为86.6%)更优。结论在宫颈HSIL及宫颈癌筛查中采用TCT联合HPV筛查敏感度和特异度均最高,但综合比较各评价指标,细胞DNA定量分析和细胞DNA定量分析并联TCT的方式更优,可进一步提高宫颈病变的诊断效能,为宫颈癌的早期诊断和治疗提供依据。Objective To explore the diagnostic efficacy of thinprep cytologic test(TCT),high-risk human papilloma virus(HPV)genotyping test,and cell DNA quantitative analysis alone and in combination in screening high-grade squamous intraepithelial lesion(HSIL)and cervical cancer(CC),in order to provide a criterion to further improve the prevention and treatment strategy of cervical cancer.Methods From December 2020 to November 2022,662 patients receiving colposcopy in the Fourth Affiliated Hospital of Soochow University with definite pathological results were selected as the study objects.A retrospective method was used to compare and analyze the sensitivity and specificity of the TCT,HPV test,cell DNA quantitative analysis three methods of screening HSIL and CC alone and in combination.Results In single screening,the order of the sensitivity from high to low were cell DNA quantitative analysis(88.9%),HPV test(84.8%),TCT(46.8%),and the specificity were TCT(94.4%),cell DNA quantitative analysis(88.1%),HPV test(20.8%).In combined screening,the sensitivity of TCT combined with HPV parallel screening was the highest(98%),and the specificity of TCT combined with HPV test tandem screening was the highest(97.2%).However,based on the combined comparison of the evaluation metrics of the fourfold table,the combination of cell DNA quantitative analysis(sensitivity 88.9%,specificity 88.1%)and cell DNA quantitative analysis parallel TCT(sensitivity 88.9%,specificity 86.6%)was better.Conclusion In HSIL and CC screening,TCT combined with HPV screening had the highest sensitivity and specificity,but individual application of cell DNA quantitative analysis and cell DNA quantitative analysis in parallel with TCT were better,which could further improve the diagnostic efficacy of HSIL and CC and provide basis for the early diagnosis and treatment of cervical cancer.

关 键 词：高危型人乳头瘤病毒 宫颈癌筛查 液基薄层细胞学检测 高级别鳞状上皮内病变 宫颈细胞DNA定量分析 

分 类 号：R737[医药卫生—肿瘤]