HPV DNA、HPV E6/E7蛋白和TCT在宫颈上皮内瘤变及宫颈癌筛查中的价值

目的 探讨人乳头瘤病毒（human papilloma virus，HPV） DNA、HPV E6/E7蛋白和液基薄层细胞学检查（thin-prep cytology test，TCT）在宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）及宫颈癌筛查中的价值。方法 选取2021年7月至2022年6月于诸暨市人民医院妇科接受早期宫颈癌筛查的成年女性190例为研究对象，分别进行HPV DNA、HPV E6/E7蛋白及TCT检测，并进一步行阴道镜活检检查。比较不同病变患者的HPV DNA、HPV E6/E7蛋白和TCT对高级别病变的诊断效能。结果 CIN3及宫颈癌患者的HPV DNA、HPV E6/E7蛋白、TCT检查及三者联合检测的阳性率均显著高于宫颈炎患者（P<0.05），宫颈癌患者的HPV DNA、HPV E6/E7蛋白、TCT检查及三者联合检测的阳性率均显著高于CIN1患者（P<0.05）。CIN2+患者的HPV DNA、HPV E6/E7蛋白、TCT及三者联合检测的阳性率显著高于CIN1–患者。HPV DNA、HPV E6/E7蛋白、TCT三者联合诊断高级别病变的敏感度、特异性、阳性预测值和阴性预测值分别为90.80%、30.10%、52.32%、79.48%。结论 HPV DNA、HPV E6/E7蛋白及TCT可作为筛查宫颈癌和癌前病变的手段，且三者联合检测的敏感度最高。

Value of HPV DNA, HPV E6/E7 protein and TCT in cervical intraepithelial neoplasia and cervical cancer screening

Objective To investigate the value of human papilloma virus (HPV) DNA, HPV E6/E7 protein and thin-prep cytology test (TCT) in cervical intraepithelial neoplasia (CIN) and cervical cancer screening. Methods A total of 190 adult women who received early cervical cancer screening in Department of Gynecology, Zhuji People’s Hospital from July 2021 to June 2022 were selected as the study objects. HPV DNA, HPV E6/E7 protein and TCT were detected, respectively, and further colposcopic biopsy was performed. The diagnostic efficacy of HPV DNA, HPV E6/E7 protein and TCT in patients with different lesions were compared. Results The positive rates of HPV DNA, HPV E6/E7 protein, TCT and combined detection in CIN3 and cervical cancer patients were significantly higher than those in cervicitis patients (P<0.05). The positive rates of HPV DNA, HPV E6/E7 protein, TCT and combined detection in cervical cancer patients were significantly higher than those in CIN1 patients (P<0.05). The positive rates of HPV DNA, HPV E6/E7 protein, TCT and combined detection in CIN2+ patients were significantly higher than those in CIN1– patients. The sensitivity, specificity, positive predictive value and negative predictive value of HPV DNA, HPV E6/E7 protein and TCT in the diagnosis of high-grade lesions were 90.80%, 30.10%, 52.32% and 79.48%, respectively. Conclusion HPV DNA, HPV E6/E7 protein and TCT can be used as screening methods for cervical cancer and precancerous lesions, with the combination of the three being the most sensitive.