光学相干层析成像技术在宫颈疾病中的应用

目的:探讨光学相干层析成像技术(optical coherence tomography,OCT)在宫颈疾病中的应用价值。方法:郑州大学第三附属医院131例宫颈液基细胞学检查(thinprep cytologic test,TCT)结果阳性或人乳头瘤病毒(human papillomavirus,HPV)高危型阳性的患者被纳入研究。被研究者均行OCT及阴道镜配合下宫颈组织活检术,以宫颈组织病理结果作为诊断“金标准”,评价3种方法的灵敏度、特异度及Kappa值。结果:从OCT图像中可以清楚地区分正常宫颈、炎症、低度鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL)、高度鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)和浸润性宫颈癌5种型别,其与相应的组织学切片的检查结果匹配良好。HPV灵敏度最高为98.25%,其次是OCT为84.21%,两者差异无统计学意义(P>0.05),均高于TCT检查(P<0.05);TCT特异度为35.14%,HPV为13.51%,与OCT(81.08%)相比差异均存在统计学意义(P<0.05);HPV,TCT及OCT三者的Kappa值分别为0.104,0.017和0.646。结论:OCT作为一种无创、高分辨率、实时快速成像技术,可以与病理切片相媲美,且具有较高的灵敏度与特异度。

Application of optical coherence tomography in cervical diseases

Objective:To discuss the application value of optical coherence tomography(OCT)in the diagnosis of cervical diseases.Methods:The study group consisted of 131 cases outpatients from the Third Affiliated Hospital of Zhengzhou University with positive results of thinprep cytologic test(TCT)or high-risk human papillomavirus(HPV).All the specimens underwent OCT and colposcopy combined with cervical biopsy.The pathological results of cervical tissue were taken as the“gold standard”for diagnosis.The sensitivity,specificity and Kappa values of the three methods were evaluated by comparing the results of HPV,TCT and OCT.Results:Distinctive patterns normal cervix,inflammation,low-grade squamous intraepithelial lesions(LSIL),high-grade squamous intraepithelial lesions(HSIL)and infiltration cervical cancer were clearly observed from OCT images,which matched well with corresponding histological slides.The highest sensitivity of HPV was 98.25%,followed by OCT of 84.21%.There was no significant difference between them(P>0.05),which was higher than TCT(P<0.05).The specificity of TCT was 35.14%and HPV was 13.51%.There were statistical differences compared with OCT(81.08%)(P<0.05).The Kappa values were 0.104,0.017,and 0.646,respectively.Conclusion:OCT,as a non-invasive,high-resolution and real-time fast imaging technology,has high sensitivity and specificity,and is worthy of clinical application.