宫颈HPV-DNA联合阴道镜检查在宫颈癌早期筛查中的临床应用

目的 探讨宫颈人乳头瘤病毒（HPV）-DNA联合阴道镜检查在宫颈癌早期筛查中的应用价值.方法 选择2011年3月至2013年2月广州市妇女儿童医疗中心妇产科收治的206例液基细胞学检查（LCT）呈阴性的接触性阴道出血患者为研究对象,采取宫颈HPV-DNA联合阴道镜检查,并与宫颈组织病理学活检结果进行比较.结果 阴道镜检查与宫颈活检、宫颈HPV-DNA检查与宫颈活检、宫颈HPV-DNA联合阴道镜检查与宫颈活检结果具有高度的一致性（P＜0.05）;宫颈HPV-DNA联合阴道镜检查用于早期诊断宫颈癌的灵敏度（90.3%）、特异度（92.7%）、阳性预测值（84.7%）及阴性预测值（95.6%）均显著优于单用宫颈HPV-DNA检查或阴道镜检查（P＜0.05）.结论 宫颈HPV-DNA联合阴道镜检查用于早期筛查宫颈癌准确率高,对于LCT呈阴性的接触性出血患者,最好采取宫颈HPV-DNA联合阴道镜检查,以提高宫颈癌早期检出率.

Clinical Application of Cervical HPV-DNA Combined Colposcope Examination in Early Cervical Cancer Screening

Objective To study the application value of cervical HPV-DNA combined colposcope exam- ination in the early cervical cancer screening. Methods From Mar. 2011 to Jan. 2013,206 cases of contact vaginal bleeding patients with negative liquid based cytology test （LCT）admitted by Women and Children＇s Medical Center in Guangzhou City were selected as the research objects, the cervical HPV DNA combined eolposcope examination was administered, and the results were compared with cervical histopathologieal biop- sy results. Results Colposcopy and cervical biopsy, cervical HPV-DNA examination and cervical biopsy, cervical HPV-DNA combined with colposcopy and cervical biopsy results had a high degree of consistency（ P 〈 0.05 ）. Cervical HPV-DNA combined with colposcope examination for early diagnosis of cervical cancer sensitivity（90.3 % ）, specificity （92.7 % ）, positive predictive value （ 84.7% ） and negative predictive value （95.6%）, were significantly superior to single use of cervical HPV~DNA examination or colposcope exami- nation （ P 〈 0.05 ）. Conclusion Cervical HPV-DNA combined colposcope examination has a high accuracy for early screening of cervical cancer, for the LCT negative contact hemorrhages, cervical HPV-DNA combined colposcope examination is the optimal option to improve the early detection rate of cervical cancer.