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目的探讨液基细胞学检查(TCT)、高危型人乳头状瘤病毒DNA(HPV-DNA)及联合检测对宫颈病变筛查的临床应用价值。方法接受宫颈病变筛查的926例患者进行TCT、HPV-DNA检测,异常者予阴道镜下活检确诊。结果 926例患者经病理检查826例确诊为无内皮病变(NILM)者,TCT检测阳性率为17.07%,25确诊为宫颈上皮内瘤变(CIN)I,TCT检测阳性率为72.35%,75例确诊为≥CIN II,TCT检测阳性率为89.33%,HPV-DNA检测阳性225例。同时HPVDNA特异性、灵敏性、漏诊率、误诊率分别为82.93%、65.00%、35.00%、17.07%;TCT特异性、灵敏性、漏诊率、误诊率分别为82.08%、66.00%、34.00%、17.92%;二者联合特异性、灵敏性、漏诊率、误诊率分别为97.58%、98.00%、2.00%、2.42%。结论临床应用宫颈TCT、HPV-DNA、阴道镜下活检进行宫颈病变早期筛查是一种有效、可行的筛查方案,可有效提高宫颈病变检出率,对宫颈癌的早期诊断与治疗有着重要的临床意义。
Objective To investigate the clinical value of liquid-based cytology (TCT), high-risk human papillomavirus DNA (HPV-DNA) and combined detection of cervical lesions screening. Methods Nine hundred and seventy-six patients who underwent screening for cervical lesions underwent TCT and HPV-DNA tests. The patients underwent colposcopy biopsy. Results The positive rate of TCT was 17.07% in 926 patients diagnosed as NILM by pathological examination. The positive rate of TCT was 25.3%, and the positive rate of TCT was 72.35% Confirmed as ≥ CIN II, TCT test positive rate was 89.33%, HPV-DNA test was positive in 225 cases. The specificity, sensitivity, missed diagnosis rate and misdiagnosis rate of HPVDNA were 82.93%, 65.00%, 35.00% and 17.07% respectively. The specificity, sensitivity, missed diagnosis rate and misdiagnosis rate of TCT were 82.08%, 66.00%, 34.00% 17.92%. The combined specificity, sensitivity, missed diagnosis rate and misdiagnosis rate were 97.58%, 98.00%, 2.00% and 2.42% respectively. Conclusion The clinical application of cervical TCT, HPV-DNA and colposcopy biopsy for early screening of cervical lesions is an effective and feasible screening program, which can effectively improve the detection rate of cervical lesions and is important for the early diagnosis and treatment of cervical cancer The clinical significance.