多种检查方法在宫颈病变筛查中的临床应用分析

目的 对比分析多种常用筛查方法早期诊断宫颈癌的临床价值.方法 病例来源于2010年4月1日-11月30日来我院宫颈门诊就诊的患者,收集门诊巴氏涂片细胞学检测、液基细胞学检测、阴道镜检查及人乳头瘤病毒(HPV)免疫组化检测的资料共1 000例,以病理检查结果为金标准,对比分析4种方法的敏感性、特异性、准确性、阳性预测值、阴性预测值、似然比及约登指数.结果 (1)宫颈巴氏涂片细胞学检测、液基细胞学检测、阴道镜检查、HPV检测诊断宫颈病变的敏感性分别为44.4%、86.8%、53.1%和98.0%;特异性分别为96.1%、91.9%、83.1%和94.8%;准确性分别为89.7%、91.1%、80.2%和95.1%;阳性预测值分别为62.1%、66.0%、25.5%和67.1%;阴性预测值分别为92.4%、97.5%、94.2%和99.8%.(2)宫颈巴氏涂片细胞学检测、液基细胞学检测与阴道镜检查联合筛查诊断宫颈病变的敏感性分别为74.3%和92.9%;阴性预测值分别为95.6%和97.9%;特异性分别为67.8%和68.0%.结论 液基细胞学检测及HPV免疫组化检测诊断宫颈癌的准确性最高,联合检查可以使其敏感性明显提高,漏诊率明显下降;液基细胞学与阴道镜联合检查更具优势,值得推广.

Application of Several Inspection Methods in Cervical Lesions Screening

Objective To compare the clinical value of common screening methods in the early diagnosis of cervical cancer.Methods A total of 1 000 cases of outpatient who underwent pap smear cytological examination,liquid base cytological(TCT) examination,colposcopy(COL),and HPV immunohistochemical detection at our cervical clinic between April 1st,2010 and November 30th,2010 were enrolled.Sensitivity(Se),specificity(Sp),positive predictive value(PPV),and negative predictive value(NPV) among these inspection methods we...