宫颈刮片、阴道镜及HPV检测在宫颈癌筛查中的应用

目的 评价宫颈刮片、阴道镜及高危HPV检测在宫颈癌筛查中的作用.方法 对发现宫颈异常的患者同时进行宫颈刮片、阴道镜检查及高危HPV检测,对一项或多项异常者行病理组织学检查,并以病理结果为金标准.对167例病检结果阳性(CIN Ⅰ、CIN Ⅱ、CIN Ⅲ、宫颈浸润癌)的患者,比较三种方法的检出敏感性、特异性、阳性预测值和阴性预测值.结果 宫颈刮片检测的敏感性为37.72%,特异性为89.01%,阳性预测值为54.07%,阴性预测值为83.74%;阴道镜检敏感性为61.08%,特异性为70.51%,阳性预测值为33.75%,阴性预测值为81.91%;高危HPV感染阳性126例,敏感性75.45%,特异性为57.51%,阳性预测值为35.2%,阴性预测值为88.45%.三种方法的敏感性比较差异有统计学意义(P＜0.05).结论 对于宫颈癌及其癌前病变的筛查及早期诊断,应以宫颈细胞学检查和阴道镜检查及高危HPV检测相互结合以提高检出率,降低假阴性.

The Application of PAP Smear, Colposcopy and HPV Test in the Screening of Cervical Cancer

Objective To evaluate the function of PAP smear, colposcopy and high risk HPV test in screening of cervical cancer and precancerous lesions. Methods The patients with abnormal cervical lesions were detected by PAP smear, colposcopy and high risk HPV test simultaneously, 167 abnormal cases were diagnosed with pathology, sensitivity of three methods were compared with each other. Results 67 cases were positive in PAP smear, their sensitivity was 37.72% , whereas 102 cases were positive in colposcopy, their sensitivity was 61.08%. And there were 126 cases with HPV-DNA positive. The difference among the three methods is significant. Conclusions We should integrate PAP smear, colposcopy and HPV test in diagnosis of cervical cancer to increase the positive rate.