FH联合TCT、高危型HPV检测筛查宫颈癌及癌前期病变价值

目的:探讨子宫上皮细胞游离亚铁原卟啉(FH)检测联合液基细胞学(TCT)或高危型人乳头瘤病毒(HPV)检测对宫颈癌及癌前期病变的筛查效能。方法:选取2016年1月-2018年1月本院妇产科行宫颈癌筛查128例,均行妇科检查、FH、TCT及HPV检测,最终经宫颈组织病理学检查。病理诊断为宫颈癌前病变13例(HSIL 5例、LSIL患者8例),宫颈癌3例,余112例未发现宫颈癌及癌前病变。采用ROC曲线分析3种检测方法单独检测及联合检测对宫颈癌及癌前病变的筛查效能。结果:FH、TCT、HPV检测诊断宫颈癌及癌前病变的ROC曲线下面积(AUC)分别为0.814、0.895、0.937,FH检测与TCT检测无差异(P>0.05),HPV检测最优。FH+TCT、FH+HPV、TCT+HPV检测诊断的AUC分别为0.793、0.903、0.950,敏感度、特异度分别为FH+TCT(87.19%、71.68%)和FH+HPV(95.01%、85.48%)。结论:子宫上皮细胞稳定性FH检测对宫颈癌的筛查具有操作简单、快速、价格低廉等优点,筛查效果与TCT检查类似,但略差于高危型HPV检测,联合检测可提高其诊断准确率。

The efficacy of FH combined with TCT or high-risk HPV detection for screening cervical cancer and precancerous lesions

Objective:To evaluate the efficacy of FH of cervical cells combined with TCT or high-risk HPV detection for screening cervical cancer and precancerous lesions.Methods:128 women who had experience cervical cancer screening were selected as subjects from January 2016 to January 2018.All these included women underwent gynecological examination,cervical histopathological examination,FH,TCT and high-risk HPV detection,and were all confirmed by cervical histopathological examination lastly.Pathological diagnosis showed 13 women with cervical precancerous lesions,which included 5 women with HSIL and 8 women LSIL.3 women with cervical cancer and 112 women without any cervical lesions were confirmed by pathological examination.ROC curve was used to analyze the efficacy of FH,TCT and high-risk HPV detection for screening cervical cancer and precancerous lesions.Results:The area under ROC curve(AUC)of FH,TCT and high-risk HPV detection were 0.814,0.895 and 0.937,respectively.There was no significant difference between FH and TCT(P>0.05),but the screening efficacy of cervical cancer HPV detection was the best.The AUC of FH combined with TCT,FH combined with HPV,and TCT combined with HPV were 0.793,0.903 and 0.950,respectively,which of TCT combined with HPV was the best.Conclusion:FH detection as uterine epithelial cell stability has the advantages of simple operation,fast,and low cost for screening cervical cancer,which screening efficacy is similar to that of TCT,but slightly worse than that of HPV detection,so FH detection combined with TCT or HPV detection can improve the accuracy of diagnosis.