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目的:评价现行3种子宫颈癌及癌前病变筛查方法的诊断效果。方法:对我院2009年1月～12月105位24～71岁妇女,均实施宫颈刮片细胞学和液基细胞学检查(TCT)、杂交捕获2代实验(HC2)检测高危型人乳头瘤病毒(HR-HPVDNA)、阴道镜取宫颈组织做病理检查,以病理检查结果为标准,≥中度宫颈上皮内瘤变(CIN2)为阳性,检测各筛查方法的灵敏度及特异度。结果:各筛查方法的灵敏度及特异度分别为:宫颈刮片细胞学检查(≥巴氏Ⅲ级为阳性)(0.829,0.615)、TCT(≥ASCUS/AGUS为阳性)(0.845,0.594)、HR-HPVDNA(≥1.00为阳性)(0.902,0.400)、宫颈刮片细胞学与HR-HPVDNA联合检测(二项均阳性)(0.780,0.677)、TCT与HR-HPV DNA联合检测(二项均阳性)(0.805,0.692)。宫颈刮片细胞学检查、TCT、宫颈刮片细胞学检查联合HR-HPV DNA、TCT联合HR-HPVDNA受试者工作特征(receiver operating characteristic,ROC)曲线下面积、可信区间(confidence interval)分别为0.719(0.620-0.819),0.724(0.625-0.822),0.729(0.629-0.828),0.749(0.652-0.849),各筛查方法筛查效率间差异无统计学意义。结论:宫颈刮片细胞学检查、液基细胞学检查(TCT)以及HR-HPV DNA检测是目前宫颈癌筛查有价值的方法,宫颈刮片细胞学检查与TCT检查相比筛查效率相似,分别联合HR-HPV DNA检测后筛查效率无明显增加。
PURPOSE: To evaluate the diagnostic efficacy of three screening methods for cervical cancer and precancerous lesions. Methods: From January 2009 to December 2009, 105 women aged 24-71 years old underwent cervical smear cytology and liquid-based cytology (TCT), and the second-generation hybridization capture test (HC2) Cervical neoplasms (HR-HPVDNA) and colposcopy were taken for histopathological examination. The results of pathological examination were as the standard, and moderate cervical intraepithelial neoplasia (CIN2) was positive. The sensitivity and specificity of each screening method were tested. Results: The sensitivity and specificity of each screening method were as follows: cervical smear cytology (≥0.829, 0.615), TCT (≥ASUSUS / AGUS positive) (0.845, 0.594) HR-HPV DNA (≥1.00 positive) (0.902,0.400), cervical smear cytology and HR-HPVDNA combined test (both positive) (0.780,0.677), combined detection of TCT and HR-HPV DNA Positive) (0.805,0.692). Cervical smear cytology, TCT, cervical smear cytology combined with HR-HPV DNA, area under the receiver operating characteristic (ROC) curve of TCT combined with HR-HPVDNA, and confidence interval 0.719 (0.620-0.819), 0.724 (0.625-0.822), 0.729 (0.629-0.828) and 0.749 (0.652-0.849), respectively. There was no significant difference in the screening efficiency among the screening methods. Conclusion: Cervical smear cytology, liquid-based cytology (TCT) and HR-HPV DNA testing is a valuable method for screening cervical cancer, cervical smear cytology and TCT screening compared screening efficiency is similar, After combined with HR-HPV DNA test no significant increase in screening efficiency.