TCT及HC2-HPV—DNA检测对绝经后妇女宫颈癌筛查的应用价值评估

目的：评价TCT、HC2-HPV—DNA单一及联合检测在绝经后妇女宫颈癌筛查中的应用价值。方法：收集北京市海淀妇幼保健院155例TCT检测提示异常的绝经后妇女，进一步行HC2-HPV—DNA检测和病理学活检。以病理诊断结果为金标准，计算TCT、HC2-HPV—DNA及两者联合检测筛查宫颈CINl／湿疣及以上病变的敏感度、特异度、假阳性率、假阴性率等指标，评价其诊断价值。结果：HC2-HPA—DNA对绝经后妇女CINl／湿疣以上病变的筛查敏感性高于TCT检测（分别为84．0％及76．0％），但其特异度明显低于后者（分别为52．4％及74．3％），两种检测均存在较高的假阳性率（25．7％及47．6％），两者联合检测可明显降低假阳性率（19．0％），并且明显提高诊断的特异度（81．0％）及诊断符合率（78．1％），两种检测方法单一或联合检测的阴性预测值无差异显著性。结论：TCT、HC2-HPA—DNA联合检测可降低筛查假阳性率，提高特异度及诊断符合率，在绝经后妇女宫颈癌筛查中具有较高的应用价值。

Application of TCT and HC2 - HPV - DNA in cervical cancer screening of postmenopa- use women

Objective：To evaluate the sensitivity and effectiveness of thinprep cytology test （TCT）, Hybrid Capture System II （HC2） for detection of human papillomavirus （HPV） and cotest of these two methods in the cervical cancer screening of postmenopause women. Methods： We compared the test results of TCT and HC2, 155 sam- ples were used. Based on the pathology diagnosis, specificity and sensitivity of these two screening methods were cal- culated. Results： HC2 had higher sensitivity （ 84. 0% ） and lower specificity （ 52.4% ） than TCT, 76.0% and 74.3% respectively. Both of them had high false positive rates, HC2 was 25.7% and TCT was 45.7%. Co - test of these two methods decreased the false positive rate to 19.0% and increased the specificity to 81.0%, and the consistency rate to 78.1%. There were no significant differences among false negative rates of TCT, HC2 and co - test. Conclusion： In the cervical cancer screening of postmenopause women, TCT and HC2 co - test decreased the false positive rate, increased the specificity and diagnosis coincidence rate. This co - test method was valuable in the cervical cancer screening of postmenopause women.