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目的探讨液基薄层细胞学(TCT)联合高危型人乳头瘤病毒(HPV)检测在宫颈癌及癌前病变诊断中的价值。方法对同一时期行TCT、高危型HPV检测的568例妇女临床资料行回顾性调查分析,所有受检者均行阴道镜活检,将其作为金标准,分析568例受检对象TCT和高危型HPV检测结果,绘制工作特征(ROC)曲线,比较曲线下面积(AUC),并探讨TCT联合高危型HPV检测在宫颈癌及癌前病变中应用价值。结果 568例受检者中79例检出宫颈病变,其中慢性宫颈炎所占比例最高,为40.51%,宫颈癌及癌前病变20例,占25.32%;54例TCT检测阳性,阳性率为9.51%,TCT阳性检测结果中ASCUS所占比例最高;高危型HPV检测结果显示568例受试者中共有56例高危型HPV阳性,阳性率为9.86%;TCT检测、高危型HPV检测和联合检测AUC分别为0.725、0.801和0.932,TCT和高危HPV检测AUC均小于联合检测,且联合检测灵敏度和准确度均明显高于TCT和高危HPV检测。结论采用TCT联合高危型HPV在宫颈癌及癌前病变筛查中应用可明显提高灵敏度和准确度,具有较高应用价值。
Objective To investigate the value of liquid-based cytology (TCT) combined with high-risk human papillomavirus (HPV) detection in the diagnosis of cervical cancer and precancerous lesions. Methods The clinical data of 568 women undergoing TCT and high-risk HPV testing in the same period were analyzed retrospectively. All the subjects underwent colposcopy biopsy as the gold standard, and 568 subjects were analyzed for TCT and high-risk HPV (ROC) curves were plotted to compare the area under the curve (AUC) and the value of TCT combined with high-risk HPV testing in cervical cancer and precancerous lesions. Results Cervical lesions were detected in 79 out of 568 subjects, of which chronic cervicitis accounted for the highest proportion of 40.51%, cervical cancer and precancerous lesions of 20 (25.32%). The positive rate of TCT was 54.1 %, The highest proportion of TCT positive test results in ASCUS; high-risk HPV test results showed that a total of 568 cases of 568 high-risk HPV positive, the positive rate was 9.86%; TCT detection, high-risk HPV testing and combined detection of AUC 0.725, 0.801 and 0.932 respectively. The AUC of TCT and high-risk HPV was lower than that of combined detection. The sensitivity and accuracy of combined detection were significantly higher than those of TCT and high-risk HPV. Conclusion TCT combined with high-risk HPV screening for cervical cancer and precancerous lesions can significantly improve the sensitivity and accuracy, with high value.