高危型人乳头瘤病毒联合宫颈液基薄层细胞学检测在宫颈上皮内瘤变筛查中的应用价值

背景据2018年全球数据统计,每年约有56万宫颈癌新发病例,宫颈癌在发展中国家的病死率尚居高位.某些欠发达地区无法满足全面开展宫颈上皮内瘤变筛查工作的需要,单项检测项目漏检风险较大.目的 探讨通过第三代杂交捕获定量分型(DH3)技术检测高危型人乳头瘤病毒(HPV)联合宫颈液基薄层细胞检测(TCT)在宫颈上皮内瘤变筛查中...

High Risk HPV Test Combined with TCT in the Screening of Cervical Intraepithelial Neoplasia

Background　According to global statistics 2018，there are about 560 000 new cases of cervical cancer every year，and the mortality rate of cervical cancer in developing countries is still high.In some underdeveloped regions without appropriate conditions for carrying out comprehensive cervical cancer screening，single screening test for cervical cancer may have a high risk of missed diagnosis.Objective　To explore the value of HPV test with TCT in the screening of cervical intraepithelial neoplasia.Methods　We enrolled 1 620 female patients who underwent cervical screening in the First Affiliated Hospital of Baotou Medical College from January to June 2020.Hybrid capture Ⅲ assay was used to detect 14 types of HPV.TCT test results were interpreted according to the cytologic classification of the Bethesda System.The cervical histopathological diagnosis was used as the gold standard to evaluate the diagnosis accuracies of HPV test，TCT，and HPV test combined with TCT.Results　Among the 1 620 patients，619 were positive for HPV and 1 001 were negative；449 were positive for TCT and 1 171 were negative；205 were positive for HPV combined with TCT and 1 415 were negative；histopathological diagnostic results were positive in 187 cases and negative in 1 433 cases.In diagnosing cervical intraepithelial neoplasia，the HPV test combined with TCT showed higher sensitivity（96.79% vs 81.28%），specificity（98.32% vs 67.41%），positive predictive value（88.29% vs 24.56%） and negative predictive value（99.56% vs 96.50%） than HPV test.And it also demonstrated higher sensitivity（96.79% vs 75.40%），specificity（98.32% vs 78.51%），positive predictive value（88.29% vs 31.40%） and negative predictive value（99.56% vs 96.07%） than TCT.Conclusion　Compared with HPV test or TCT，HPV test combined with TCT showed higher sensitivity，specificity，positive and negative predictive values，thereby reducing the possibilities of rates of missed diagnosis and misdiagnosis，demonstrating higher clinical value.