电子阴道镜联合新柏氏膜式液基细胞学检测诊断宫颈人乳头瘤病毒亚临床感染和宫颈上皮内瘤变

目的 探讨新柏氏膜式液基细胞学检测(TCT)和电子阴道镜(EC)检查对宫颈人乳头瘤病毒亚临床感染(SPI)和宫颈上皮内瘤变(CIN)的诊断价值及其与病理诊断的一致性.方法 1 125例妇女行TCT筛查,744例TCT检测结果异常或可疑宫颈病变者行EC检查,并对706例异常EC图像者或可疑病变者行镜下多点活检.结果 TCT、EC和EC联合TCT检查诊断SPI、CIN和宫颈炎的灵敏度分别为88.74%、88.79%和90.63%;特异度分别为85.44%、80.38%和96.41%;阳性预测值分别为74.06%、68.90%和91.10%,阴性预测值分别为94.19%、93.61%和96.21%.两种方法联合应用的特异度和阳性预测值较单独采用一种检查明显增高(P<0.05).结论 TCT适合作为筛查官颈病变的参考指标,联合Ec对宫颈病变定位并镜下活检,结合组织病理学检查可提高对宫颈SPI和CIN的早期诊断率,是准确、可靠的诊断方法.

Electrocolposcopic and thinprep cytologic test in diagnosis of subclinical human papillomavirus infection and cervical intraepithelial neoplasia

Objective To investigate the diagnostic value of thinprep cytologic test(TCT) and electronic colposcope(EC) examination in patients with subclinical human papillomavirus(HPV) infection(SPI) and cervical intraepithelial neoplasia(CIN),and explore its concordance with pathologic diagnosis. Methods A total of 1 125 females were examined with TCT,744 of whom diagnosed with abnormality by TCT or suspect of cervical lesions were examined with EC,and multiple punch biopsies were performed in 706 of those with abnomal EC images and suspected diseases. ResultsThe sensitivity of TCT,EC examination and the combined examination of TCT and EC for SPI and CIN were 88.74%,88.79% and 90.63%,respectively,the specificity 85.44%,80.38% and 96.41%,respectively,the positive predictive value 74.06%,68.90% and 91.10%,respectively,and the negative predictive value 94.19%,93.61% and 96.21%,respectively.By the combination of the two examinations,the specificity and positive predictive value were significantly increased(P<0.05). Conclusion TCT is an appropriate reference index in screening of cervix lesions.TCT in combination of EC,which can locate cervical lesions with colposcopic biopsies of the cervix and pathologic examination,may increase the early diagnosis rate for SPI and CIN and is an accurate and reliable diagnostic method.