液基细胞学联合HPV DNA检测在宫颈癌筛查中的临床意义

目的评价意义不明确的宫颈非典型鳞状上皮细胞(ASCUS)的临床意义和细胞病理学特点及联合薄层细胞涂片检测高危型人乳头瘤病毒(HPV)对筛查高度宫颈上皮内瘤变的价值。方法对受检病例进行液基细胞学及人乳头瘤病毒(HPV)DNA检测,以组织学为金标准,以灵敏度、特异度、准确性、阳性预测值、阴性预测值为评价指标,评价两种方法对宫颈癌及癌前病变的筛查价值。结果 HPV感染发生率为21.3%,CINⅡ及以上的检出率(72.5%)高于CINⅠ(23.5%),两者差异有显著性(P<0.05)。以组织学诊断为标准,以未明确诊断意义的不典型鳞状上皮细胞(AUSCUS)为分界点,HC2、液基细胞学及联合两种方法的灵敏度分别为89%、92%、100%;特异度分别为88.8%、92.1%、83.1%(P<0.05);阳性预测值为20.5%、23.5%、21.1%(P>0.05);阴性预测值为95.8%、96.7%、99.4%(P<0.05)。结论联合应用液基细胞学和HPV DNA检测是检测宫颈病变的有效筛查方法,细胞学异常或临床怀疑异常,应结合阴道镜做进一步诊断,有利于提高宫颈病变的检出率。

Clinical Significance of Liquid Based Cytology Combined with HPV DNA Detection in the Cervical Cancer Screening

Objectives To investigate the clinical significance and pathological features of cervical atypical squamous cell of undermined signification(ASCUS) and the value of the liquid based cytology combined with human pap illomavirus(HPV) DNA test for high grade intraepithelial neoplasia.Method The liquid based cytology and the HPV DNA were tested in 1170 cases.The results were evaluated by the colposcopic biopsy which was considered as gold standard and were compared with the index of sensitivity,specificity,accu...