宫颈液基细胞学检查和杂交捕获二代HPV检测在宫颈癌群体筛查中的价值

目的评价液基细胞学检查(LCT)和杂交捕获二代(HC-Ⅱ)人乳头状瘤病毒(HPV)两种方法不同组合的筛查方案在宫颈癌群体筛查中的价值。方法采用LCT和HC-ⅡHPV两种方法对2004年5月～2009年5月深圳市25～59岁群体妇女共5217例进行同步宫颈癌筛查,对两种检查方法任一项有异常者行阴道镜检查,以病理结果作为最终诊断,评价不同组合的筛查方案在宫颈癌群体筛查中的价值。结果随着宫颈病变级别升高,高危型HPV感染率及LCT阳性率增加(P0.05)。比较六种方案对筛查宫颈上皮内瘤变(CIN)2级及以上病变的价值:HC-ⅡHPV比LCT敏感性高,HPV-LCT平行实验的敏感性和阴性预测值高,以HPV为基础的筛查其特异性和阳性预测值高,HPV-LCT系列实验可减少阴道镜检查的数目,以LCT为基础的筛查可减少筛查实验的数目。结论LCT和HC-ⅡHPV检测均是目前宫颈癌筛查有价值的方法,在宫颈癌群体筛查中,应根据实际情况选择两种方法不同组合的筛查方案。

Different Combination of Liquid-based Cervical Cytological Detection and Hybrid Capture II Human Papillomavirus Test in Cervical Cancer Screening

Objective To evaluate the efficacy of different combination of liquid-based cervical cytological test（LCT） and hybrid capture II （HC-Ⅱ）human papillomavirus （HPV）test in cervical cancer screening. Methods HC- ⅡHPV test and LCT were performed for cervical cancer screening in 5217 women aged 25-59 years in Shenzhen from May 2004 to May 2009. Any of the women with positve results by HC-Ⅱ HPV test or abnormal cytology underwent colposcopy examination. We used pathological results as the final diagnosis to evaluate the value of different combination of the two tests in cervical cancer screening. Results The HPV-positive rate and LCT-positive rate were increased with the increased level of cervical lesions（ P〈0.05 ）. We compared the values of six schemes of the combination in detecting cervical intraepithelial neoplasia（CIN ） grade 2 or above and found that the HC-Ⅱ HPV test was more sensitive than LCT, the HPV-LCT parallel test showed higher sensitivity and negative prediction value（NPV ）, the HPV-based screening showed higher specificity and positive prediction value（PPV）, the HPV-LCT series tests reduced the number of colposcopy examination and the LCT-based screening reduced the number of screening. Conclusion Both HC-Ⅱ HPV test and LCT are valuable in screening cervical cancer at present. We should select the scheme of their different combination based on our needs in cervical cancer screening.