阴道镜下活检、TCT及HPV检测对宫颈病变的临床应用分析

目的:探讨阴道镜下活检、宫颈液基薄层细胞学检查(TCT)及人乳头瘤病毒(HPV)检测对宫颈病变的临床价值。方法:2017年3月~2019年3月收治的427例妇女均进行TCT检查,其中315例同时进行了HPV检查,对其中高度怀疑有宫颈病变的239例进行阴道镜活检,以活检病理学为金标准,判断TCT、HPV的敏感性、特异性、阳性预测值、阴性预测值。结果:活检病理学证实,正常或炎症改变93例(38.9%),CINⅠ39例(16.3%),CINⅡ48例(20.1%),CINⅢ28例(11.7%),宫颈癌31例(13.0%)。以活检病理学为金标准,TCT的敏感性为63.7%,特异性为61.9%,阳性预测值为77.4%,阴性预测值为48.1%。HPV的敏感性为94.8%,特异性39.4%,阳性预测值为60.5%,阴性预测值为44.8%。结论:HPV检测宫颈疾病的敏感性高,灵活运用多种检测方法对宫颈病变的早期发现、早期诊断有重要意义。

Analysis of Clinical Application of Biopsy,TCT and HPV Detection Under Colposcopy in Cervical Lesions

Objective:To explore the clinical value of colposcopy biopsy,cervical liquid-based thin-layer cytology(TCT)and human papillomavirus(HPV)detection for cervical lesions.Methods:From March 2017 to March 2019,427 women underwent TCT examination.315 of them underwent HPV examination at the same time.Among them,239 cases were highly suspected of cervical lesions underwent colposcopy biopsy.Biopsy pathology was the gold standard,to determine the sensitivity,specificity,positive predictive value,and negative predictive value of TCT and HPV.Results:Pathologically confirmed by biopsy,93 cases(38.9%)were normal or inflammatory changes,39 cases(16.3%)were CINⅠ,48 cases were CINⅡ(20.1%),28 cases were CINⅢ(11.7%),and 31 cases(13.0%)were cervical cancer.Taking biopsy pathology as the gold standard,TCT has a sensitivity of 63.7%,a specificity of 61.9%,a positive predictive value of 77.4%,and a negative predictive value of 48.1%.The sensitivity of HPV was 94.8%,the specificity was 39.4%,the positive predictive value was 60.5%,and the negative predictive value was 44.8%.Conclusion:HPV has high sensitivity in detecting cervical diseases,and the flexible use of multiple detection methods is of great significance for early detection and early diagnosis of cervical lesions.