HPV-DNA亚型检测联合液基细胞学对宫颈癌筛查的临床价值

目的:研究HPV-DNA检测联合液基细胞学(TCT)对宫颈癌筛查的临床应用价值。方法:选择妇科门诊宫颈癌筛查患者2 458例为研究对象,同时行PCR-反向点杂交法、液基细胞学检测,并以宫颈活检组织病理学检查为金标准,比较2种方法及联合应用的灵敏度、特异度、符合率、正确诊断指数、阴阳性预测值。结果:病理学检查不同CIN分级组别及正常组HPV感染的阳性率两两比较均存在统计学差异(P<0.05),TCT阳性率不同CIN分级组别与正常组比较均存在统计学差异(P<0.05);方法学比较TCT灵敏度高于HPV-DNA检测,特异度低于HPV-DNA检测,两种方法联合检测灵敏度、特异度分别为96.1%、98.6%。结论:HPV-DNA检测联合TCT能很好的提高检测方法的灵敏度、特异度,对宫颈癌的早期筛查有重要的临床应用价值。

Value of HPV-DNA subtype detection combined with liquid based cytology in cervical cancer screening

Objective: To study the value of HPV-DNA detection combined with liquid-based cytology(LCT) for cervical cancer screening.Methods: A total of 2 458 cervical cancer cases were selected.They underwent PCR-reverse dot blot hybridization,and LCT test.With cervical biopsy and histopathological examination as the gold standard,the sensitivity,specificity,accuracy,correct diagnosis index,positive predictive value and negative predictive value were observed and compared among two methods respectively and the combined application.Results: Pathological examination showed significant difference in positive rate of HPV infection among different CIN groups and normal group(P<0.05),and significant difference in positive rate among CIN groups with different positive rate of LCT and normal group(P<0.05);methodological comparison revealed sensitivity of LCT was higher than that of HPV-DNA detection,but the specificity of LCT was lower than HPV-DNA detection.The sensitivity,specificity of combination detection was 96.1%,98.6%,respectively.Conclusions: Detection of HPV-DNA combined with LCT can improve sensitivity and specificity of cervical cancer screening.It is valuable in early screening of cervical cancer.