[1]罗 晶,李婷婷,王 倩,等.液基薄层细胞学检查、人乳头状瘤病毒检测及阴道镜检查在宫颈癌前病变及宫颈癌筛查中的应用价值[J].新乡医学院学报,2021,38(5):427-430.[doi:10.7683/xxyxyxb.2021.05.006]
 LUO Jing,LI Tingting,WANG Qian,et al.Application value of thin-prep cytology test,human papillomavirus test and colposcopy in the screening of cervical precancerous lesions and cervical cancer[J].Journal of Xinxiang Medical University,2021,38(5):427-430.[doi:10.7683/xxyxyxb.2021.05.006]
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液基薄层细胞学检查、人乳头状瘤病毒检测及阴道镜检查在宫颈癌前病变及宫颈癌筛查中的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年5
页码:
427-430
栏目:
临床研究
出版日期:
2021-05-05

文章信息/Info

Title:
Application value of thin-prep cytology test,human papillomavirus test and colposcopy in the screening of cervical precancerous lesions and cervical cancer
作者:
罗 晶李婷婷王 倩付晓飞秦海霞侯瑞杰秦瑞英王世进
(新乡医学院第一附属医院妇科,河南 卫辉 453100)
Author(s):
LUO JingLI TingtingWANG QianFU XiaofeiQIN HaixiaHOU RuijieQIN RuiyingWANG Shijin
(Department of Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
液基薄层细胞学检查人乳头状瘤病毒阴道镜检查宫颈癌前病变宫颈癌筛查
Keywords:
thin-prep cytology testhuman papillomaviruscolposcopycervical precancerous lesionscervical cancerscreening
分类号:
R737.33
DOI:
10.7683/xxyxyxb.2021.05.006
文献标志码:
A
摘要:
目的 探讨液基薄层细胞学检测(TCT)、人乳头状瘤病毒(HPV)检测、阴道镜检查在宫颈癌前病变及宫颈癌筛查中的应用价值。方法 回顾性分析2019年5月至2020年4月于新乡医学院第一附属医院同时行TCT、HPV检测及阴道镜检查的459例疑似宫颈病变患者的临床资料。以组织学结果为 “金标准”,分析TCT、HPV检测、阴道镜检查在宫颈癌前病变及宫颈癌筛查中的价值。结果 459例疑似宫颈病变患者经宫颈活体组织检查确诊为宫颈病变者157例,其中低级别鳞状上皮内病变59例、高级别鳞状上皮内病变80例、宫颈癌18例。459例疑似宫颈病变患者中,TCT筛查阳性292例(阳性率63.62%),HPV筛查阳性342例(阳性率74.51%),TCT和 HPV联合筛查阳性456例(阳性率99.35%)。TCT在宫颈癌前病变及宫颈癌诊断中的灵敏度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率、准确度分别为63.69%(100/157)、36.42%(110/302)、34.25%(100/292)、65.87%(110/167)、63.58%(192/302)、36.31%(57/157)、47.93%(220/459);HPV检测在宫颈癌前病变及宫颈癌诊断中的灵敏度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率、准确度分别为89.17%(140/157)、33.11%(100/302)、40.94%(140/342)、85.47%(100/117)、66.89%(202/302)、10.83%(17/157)、52.29%(240/459);TCT和HPV联合检测在宫颈癌前病变及宫颈癌诊断中的灵敏度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率、准确度分别为98.73%(155/157)、0.33%(1/302)、33.99%(155/456)、33.33%(1/3)、99.67%(301/302)、1.27%(2/157)、33.99%(156/459)。HPV检测在宫颈癌前病变及宫颈癌诊断中的灵敏度、阴性预测值高于TCT检测,假阴性率低于TCT(P<0.05);TCT与HPV检测在宫颈癌前病变及宫颈癌诊断中的特异度、阳性预测值、假阳性率、准确度比较差异无统计学意义(P>0.05)。TCT和HPV联合检测在宫颈癌前病变及宫颈癌诊断中的灵敏度、假阳性率高于TCT,特异度、假阴性率、准确度低于TCT(P<0.05);TCT和HPV联合检测与单独TCT在宫颈癌前病变及宫颈癌诊断中的阳性预测值、阴性预测值比较差异无统计学意义(P>0.05)。TCT和HPV联合检测在宫颈癌前病变及宫颈癌诊断中灵敏度、假阳性率高于单独HPV检测,特异度、假阴性率、阳性预测值、阴性预测值、准确度低于单独HPV检测(P<0.05)。病理学检查确诊为宫颈病变的患者157例,TCT检出率为63.69%(100/157),HPV检出率为89.17%(140/157),阴道镜检出率为86.62%(136/157),TCT、HPV及阴道镜检查三者联合检出率为100.00%(157/157);HPV检测、阴道镜检查的检出率均高于TCT(P<0.05),HPV检测和阴道镜检查的检出率比较差异无统计学意义(P>0.05),TCT、HPV、阴道镜检查联合检测的检出率高于三者单独检测(P<0.05)。结论 TCT、HPV和阴道镜检查联合检测在宫颈癌筛查中具有高检出率、低漏诊率、无创、经济等优点,对早期发现宫颈病变有重要意义。
Abstract:
Objective To investigate the value of thin-prep cytology test (TCT),human papillomavirus (HPV) test and colposcopy in the screening of cervical precancerous lesions and cervical cancer.Methods  The clinical data of 459 patients with suspected cervical lesions who underwent TCT,HPV test and colposcopy in the First Affiliated Hospital of Xinxiang Medical University from May 2019 to April 2020 were retrospectively analyzed.The value of TCT,HPV and colposcopy in cervical precancerous lesions and cervical cancer screening were analyzed based on the histological results.Results Among the 459 cases of suspected cervical lesions,157 cases were diagnosed as cervical lesions by cervical biopsy,including 59 cases of low-grade squamous intraepithelial lesion,80 cases of high-grade squamous intraepithelial lesion and 18 cases of cervical cancer.Among the 459 patients with suspected cervical lesions,292 (63.62%) cases were positive by TCT,342 (74.51%) cases were positive by HPV,and 456 cases (99.35%) were positive by TCT combined with HPV.The sensitivity,specificity,Positive predictive value,negative predictive value,false positive rate,false negative rate and accuracy of TCT in the diagnosis of cervical precancerous lesions and cervical cancer were 63.69% (100/157),36.42% (110/302),34.25% (100/292),65.87% (110/167),63.58% (192/302),36.31% (57/157) and 47.93% (220/459),respectively.The sensitivity,specificity,Positive predictive value,negative predictive value,false positive rate,false negative rate and accuracy of HPV detection in the diagnosis of cervical precancerous lesions and cervical cancer were 89.17% (140/157),33.11% (100/302),40.94% (140/342),85.47% (100/117),66.89% (202/302),10.83% (17/157) and 52.29% (240/459),respectively.The sensitivity,specificity,Positive predictive value,negative predictive value,false positive rate,false negative rate and accuracy of TCT combined with HPV in the diagnosis of cervical precancerous lesions and cervical cancer were 98.73% (155/157),0.33% (1/302),33.99% (155/456),33.33% (1/3),99.67% (301/302),1.27% (2/157) and 33.99% (156/459),respectively.The sensitivity and negative predictive value of HPV detection in the diagnosis of cervical precancerous lesions and cervical cancer were higher than those of TCT,and the false negative rate was lower than that of TCT (P<0.05).There was no significant difference in specificity,Positive predictive value,false positive rate and accuracy between TCT and HPV in the diagnosis of cervical precancerous lesions and cervical cancer (P>0.05).The sensitivity and false positive rate of TCT combined with HPV in the diagnosis of cervical precancerous lesions and cervical cancer were higher than those of TCT,and the specificity,false negative rate and accuracy were lower than those of TCT (P<0.05).There was no significant difference in positive predictive value and negative predictive value between TCT and HPV combined detection and only TCT in the diagnosis of cervical precancerous lesions and cervical cancer (P>0.05).The sensitivity and false positive rate of combined detection of TCT combined with HPV in the diagnosis of cervical precancerous lesions and cervical cancer were higher than those of HPV detection alone,while the specificity,false negative rate,Positive predictive value,negative predictive value and accuracy were lower than those of HPV detection alone (P<0.05).Among the 157 cases of cervical lesions were confirmed by pathological examination,the detection rate of TCT was 63.69% (100/157),the detection rate of HPV was 89.17% (140/157),the detection rate of colposcopy was 86.62% (136/157),and the detection rate of combined detection of TCT,HPV and colposcopy was 100.00% (157/157).The detection rate of HPV detection and colposcopy was higher than that of TCT (P<0.05).There was no significant difference in the detection rate between HPV detection and colposcopy (P>0.05).The detection rate of TCT,HPV and colposcopy combined detection was higher than that of TCT alone (P<0.05).Conclusion The combined detection of TCT,HPV and colposcopy in cervical cancer screening has the advantages of high detection rate,low missed diagnosis rate,non-invasive and low cost,which is important for early detection of cervical lesions.

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更新日期/Last Update: 2021-05-05