高危型HPV-DNA及TCT检测筛查宫颈癌及宫颈癌前病变的价值

目的 研究高危型人乳头瘤病毒-DNA（HPV-DNA）及液基薄层细胞检测系统（TCT）检测筛查宫颈癌及宫颈癌前病变的价值。方法 选择2016年3月~2019年2月本院收治的宫颈病变患者200例，所有患者均行高危型HPV-DNA检测、TCT检查，先行高危型HPV-DNA和TCT单项检测，再行联合检测:T1（先高危型HPV-DNA，再TCT）、T2（先TCT，再高危型HPV-DNA）。随访记录其病理检查结果，以病理检查结果为“金标准”，评估各检测方法的敏感性、特异性、准确度。结果 本研究中经组织病理学检查证实阴性168例（慢性宫颈炎），阳性32例（CINⅠ级及以上），其中CINⅠ16例，CINⅡ~Ⅲ15例，浸润性癌1例；高危型HPV-DNA检测宫颈癌前病变及宫颈癌的敏感性高于TCT、T2，特异性、准确度低于TCT、T2、T1，差异有统计学意义（P＜0.05）；T1诊断宫颈癌及宫颈癌前病变的特异性、准确度均高于高危型HPV-DNA、TCT，差异有统计学意义（P＜0.05）；T1准确度、敏感性均高于T2，差异有统计学意义（P＜0.05）。结论 高危型HPV-DNA及TCT检测在筛查宫颈癌及宫颈癌前病变方面各具优势，而先行高危型HPV-DNA检测再行TCT检测筛选价值更高。

The Value of Screening High-Risk HPV-DNA and TCT for Cervical Carcinoma and Cervical Precancerous Lesions

Objective To study the value of high-risk human papillomavirus-DNA (HPV-DNA) and liquid-based thin-layer cell detection system (TCT) in screening cervical carcinoma and cervical precancerous lesions. Methods 200 patients with cervical lesions admitted to our hospital from March 2016 to February 2019 were selected. All patients underwent high-risk HPV-DNA testing and TCT testing. The high-risk HPV-DNA and TCT single-test were performed first, followed by joint testing: T1 (first high-risk HPV-DNA, then TCT), T2 (first TCT, then high-risk HPV-DNA). The pathological examination results were followed up, and the pathological examination results were regarded as "gold standard". The sensitivity, specificity and accuracy of each detection method were evaluated. Results In this study, 168 cases (chronic cervicitis) and 32 cases (CINI grade and above) were confirmed by histopathological examination, including 16 cases of CINI, 15 cases of CINII~III, and 1 case of invasive carcinoma. High-risk HPV-DNA detection the sensitivity of cervical precancerous lesions and cervical carcinoma was higher than that of TCT and T2. The specificity and accuracy were lower than TCT, T2 and T1,the difference was statistically significant (P<0.05). T1 diagnosis of cervical cancer and cervical precancerous lesions the specificity and accuracy were higher than those of high-risk HPV-DNA and TCT,the difference was statistically significant (P<0.05). The accuracy and sensitivity of T1 were higher than T2,the difference was statistically significant (P<0.05).Conclusion The high-risk HPV-DNA and TCT tests have advantages in screening cervical carcinoma and cervical precancerous lesions, and the high-risk HPV-DNA test has a higher value for TCT detection.