TCT联合高危型HPV检测在社区宫颈癌筛查中的应用价值

目的：探讨宫颈液基薄层细胞学检查(TCT)联合高危型人乳头状瘤病毒(HPV)检测在社区宫颈癌筛查中的应用价值。方法随机抽取育德社区2011年1月至2014年10月行TCT和高危HPV检测的已婚妇女1100例作为研究对象，TCT或高危型HPV任一检查结果阳性者行病理组织检查，以病理组织检查为金标准，比较TCT和高危HPV筛查宫颈癌的灵敏度和特异度。结果1100例受检者的TCT阳性78例，阳性率为7.09%，高危型HPV阳性106例，阳性率为9.64%。TCT、HPV双阳性2例，TCT (阳)、HPV (阴)1例，TCT(阴)、HPV(阳)0例，TCT、HPV双阴性0例。TCT灵敏度为100.00%，特异度为62.93%；高危型HPV灵敏度为66.67%，特异度49.27%；TCT联合HPV (串联)灵敏度为66.67%，特异度为25.85%；TCT联合HPV（并联）灵敏度为100.00%，特异度为86.34%。不同检测方法检测宫颈癌的灵敏度和特异度比较差异具有统计学意义(P<0.05)。结论 TCT联合高危型HPV (并联)检测可以提高宫颈癌筛查的灵敏度和特异性，对于社区筛查宫颈癌具有重要的应用价值。

Application value of TCT combined with HPV detection in cervical cancer screening in community

Objective To investigate the application value of thinprep cytologic test (TCT) combined with high-risk hu-man papilloma virus (HPV) detection in cervical cancer screening in community. Methods A total of 1 100 married women with TCT and high-risk HPV from Yudei Community were randomly selected as subjects from January 2011 to October 2014. Patients with positive results in TCT or high-risk HPV test were examined by pathological examination. The sensitivity and specificity of TCT and high-risk HPV for cervical cancer screening were compared. Results Among 1 100 cases, the TCT was positive in 78 cases (accounting for 7.09%), and the high-risk HPV was positive in 106 cases (accounting for 9.64%). Among them, TCT, HPV were both positive in 2 cases. TCT-positive and HPV-negative, TCT-negative and HPV-positive, TCT-negative and HPV-negative were found in 1, 0, 0 case, respectively. The sensitivity and specificity of TCT was 100.00%and 62.93%. The sensitivity of high-risk HPV types was 66.67%and specificity was 49.27%. The sensitivity and specificity of TCT combined with HPV (Series) were 66.67%and 25.85%, respectively. The sensitivity and specificity of TCT combined with HPV (parallel) were 100.00% and 86.34%, respectively. There were significant differences in the sensitivity and specificity of different detection methods for detection of cervical cancer (P<0.05). Conclusion TCT combined with high-risk HPV (parallel) can improve the sensitivity and specificity of cervical cancer screening, which is of great value for the diagnosis of cervical cancer in community.