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目的评价薄层液基细胞学检测(ThinPrep cytologic test,TCT)对宫颈癌及癌前病变的诊断价值,探讨切割点的临床意义。方法可疑宫颈癌或癌前变患者373例均行TCT和宫颈组织活检,以活检组织病理结果为金标准,进行试验性评价。结果 TCT诊断宫颈上皮内瘤变和宫颈癌的ROC曲线下面积为0.834(95%CI为0.792～0.875);在TCT分级标准正常范围与非典型鳞状上皮细胞间切割时,真阳性为0.886,真阴性为0.566,阳性预测值为0.643,阴性预测值为0.849,一致率为71.58%;在典型鳞状上皮细胞与低度鳞状上皮内病变间切割时,真阳性为0.629,真阴性为0.904,阳性预测值为0.853,阴性预测值为0.734,一致率为77.48%。结论 TCT是宫颈癌及癌前病变筛查的有效方法。
Objective To evaluate the diagnostic value of ThinPrep cytologic test (TCT) for cervical cancer and precancerous lesions and to explore the clinical significance of cutting point. Methods 373 cases of suspected cervical cancer or precancerous lesions were performed TCT and cervical biopsy, biopsy histopathological results as the gold standard for experimental evaluation. Results The area under the ROC curve of TCT in the diagnosis of cervical intraepithelial neoplasia and cervical cancer was 0.834 (95% CI 0.792-0.875). The true positive was 0.886 when cut between the normal range of TCT classification and the atypical squamous epithelium, The true negative was 0.566, the positive predictive value was 0.643, the negative predictive value was 0.849, and the concordance rate was 71.58%. The true positive was 0.629 and the true negative was 0.904 when cut between typical squamous cell and low grade squamous intraepithelial lesion , The positive predictive value was 0.853, the negative predictive value was 0.734, the concordance rate was 77.48%. Conclusion TCT is an effective method for screening cervical cancer and precancerous lesions.