宫颈液基细胞学检查在宫颈癌筛查中的诊断价值分析

目的：分析液基细胞学检查在宫颈癌筛查中的诊断价值，探讨其临床适用性。方法：选择从2011年9月到2012年9月于我院进行保健筛查的645例已婚女性患者进行TCT检查，对细胞学检查筛查出的ASC－US及以上病变患者进行HPV－DNA检测和在阴道镜下进行病理组织学检查。观察各种检查方法的阳性比率及阴性比率，比较TCT检查方法和HPV－DNA 检测方法的灵敏度和特异度情况。结果：TCT检查中ASC－US 及以上病变201例，其中阴性139例，阳性62例。病理组织学检查结果：TCT阴性139例，其中组织学阴性129例，阴性率92.8％；组织学阳性10例，阳性率7.2％；TCT 阳性62例，其中组织学阴性31例，阴性率50.0％；组织学阳性31例，阳性率50.0％。而HPV－DNA检测阴性97例，阳性104例。病理组织学检查结果：HPV－DNA 阴性97例中，组织学阴性94例，阴性率96.9％，阳性3例，阳性率3.1％；HPV－DNA 阳性104例，其中组织学阴性68例，阴性率65.4％，阳性36例，阳性率34.6％。两种检测方法比较结果为TCT特异度和准确度远高于HPV－DNA检测，差异有统计学意义（P＜0.05），而HPV－DNA检测敏感度高于TCT。结论：宫颈液基细胞学检查是一种简单且准确率较高的宫颈癌和前期病变筛查方法，特异性比较强，且可以降低漏诊率，对早期检查和预防宫颈病变中具有较高的诊断价值，适合临床长期推广应用。

Diagnostic value of liquid -based cervical cytology in cervical cancer screening

Objectives：To analyze the diagnostic value of liquid-based cytology in cervical cancer screen-ing,and to explore its clinical applicability.Methods：645 married women that conducted health screenings in our hospital from September 201 1 to September 2012 were selected.All the patients received TCT examination,and the HPV-DNA lesions detection and histopathological examination was carried out on patients whose cytology screening results was ASC-US or above.Observed the positive rate and negative rate with various inspection methods,and compared the sensitivity and specificity in the situation TCT inspection methods and HPV-DNA detection method. Results：The TCT examination results of 201 cases were ASC-US or above,including 139 negative and 62 positive cases.According to histopathological outcome：139 cases were TCT negative,of which 129 cases were histologically negative,negative rate of 92.8% and 10 cases were histologically positive,positive rate of 7.2%;62 cases were TCT positive,of which 31 cases were histologically negative,negative rate of 50.0%and 31 cases were histological-ly positive,positive rate of 50.0%.There were 97 cases and 104 cases HPV-DNA test negative and positive re-spectively.According to histopathological outcome：97 cases were HPV -DNA negative,of which 94 cases were histologically negative,negative rate of 96.9%,and 3 cases were positive,positive rate of 3.1%;104 cases were HPV-DNA positive,of which 68 cases were histologically negative,negative rate of 65 .4% and 36 cases were positive,positive rate of 34.6%.Comparing the results of the two detection methods,the specificity and accuracy of TCT were much higher than those of HPV-DNA testing,with statistically significant difference （P〈0.05 ）,but HPV-DNA detection had higher sensitivity than the TCT.Conclusions：Liquid-based cervical cytology is a sim-ple and cervical cancer and precancerous lesion screening methods of high accuracy and specificity,which,with a high diagnostic value for the early detection and prevention of cer