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目的探讨液基薄层细胞学、细胞DNA定量分析、HPV DNA检测及阴道镜宫颈活检组织病理检查在宫颈癌及癌前病变诊断中的价值。方法分析172例同时进行宫颈液基薄层细胞学及DNA定量分析检测的病例,其中86例有HPV DNA检测结果,81例有活检组织病理诊断结果,比较其检查结果的吻合情况。结果以ASC-H为液基细胞学阳性界值,发现宫颈阳性病变的敏感性为75%(24/32),特异性为83.7%(41/49),准确性为80.3%(65/81);以DNA定量分析结果阳性为活检标准,则发现宫颈阳性病变的敏感性为78.4%(29/37),特异性为93.2%(41/44),准确性为86.4%(70/81);DNA定量分析检测与液基细胞学的诊断结果吻合率为85.5%;以HPV DNA检测结果阳性为活检标准,则发现宫颈阳性病变的敏感性为63.8%(30/47),特异性为94.4%(17/18),准确性为72.3%(47/65)。结论采用联合检查方法可以提高宫颈癌及癌前病变的检出率。
Objective To investigate the value of liquid-based thin-layer cytology, quantitative DNA analysis, HPV DNA detection and colposcopy biopsy histopathology in the diagnosis of cervical cancer and precancerous lesions. Methods A total of 172 cases of simultaneous cervical cytology thin layer cytology and DNA quantitative analysis were analyzed. Among them, 86 cases had HPV DNA test results and 81 cases had biopsy histopathological diagnosis results. The anastomosis results of the test results were compared. Results ASC-H was found to have a positive liquid-based cytometry cutoff value of 75% (24/32), specificity of 83.7% (41/49), and accuracy of 80.3% (65/81 ). The positive results of DNA quantitative analysis were biopsy criteria. The sensitivity of positive cervical lesions was 78.4% (29/37), specificity was 93.2% (41/44), and the accuracy was 86.4% (70/81) . The coincidence rate of DNA quantitative analysis and liquid-based cytology was 85.5%. The HPV positive rate was 63.8% (30/47) and the specificity was 94.4 % (17/18) with an accuracy of 72.3% (47/65). Conclusion The combined examination can improve the detection rate of cervical cancer and precancerous lesions.