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目的:探讨和分析高危型HPV-DNA检测联合TCT应用于宫颈病变筛查的效果。方法:选取该院2012年1月~2013年12月期间的172例患者进行癌前病变和宫颈癌筛查。并对患者采用高危型HPV-DNA检测和TCT及阴道镜下病理活体组织检查(活检),最终以病理检查结果为金标准。同时比较前两者之间所存在的关系。结果:经病理诊断发现,其中164例患者为良性病变或无上皮内病变,2例为宫颈上皮内瘤样病变(CINⅠ),5例为CINⅡ/Ⅲ,1例宫颈癌。其中TCT检测结果在正常范围内患者为134例,ASC-US为25例,低度鳞状上皮内病变患者(LSIL)为10例,高度鳞状上皮内病变患者(HSIL)为3例。高危型HPV-DNA检测结果为阳性患者为39例。而TCT检测敏感度为94.34%(150/159)、特异度为61.54%(8/13)、准确度为91.86%(158/172)、阳性预测值为97.77%(150/155)、阴性预测值为47.06%(8/17);然而联合检测敏感度为98.18%(162/165)、特异度为85.71%(6/7)、准确度为97.67%(168/172)、阳性预测值为99.39%(162/163)、阴性预测值为66.67%(6/9)。结论:相比单独采用TCT或高危型HPV-DNA检测,联合检测能有效提高宫颈癌前病变阳性检出率,同时降低漏诊率,进而为临床诊断和治疗提供一定的参考依据,保障女性患者生命健康安全。
Objective: To investigate and analyze the effect of high-risk HPV-DNA combined with TCT in cervical lesions screening. Methods: A total of 172 patients from January 2012 to December 2013 in our hospital were selected for precancerous lesions and cervical cancer screening. High-risk HPV-DNA test and pathological biopsy (biopsy) with TCT and colposcopy were performed on the patients. Finally, the result of pathological examination was the gold standard. At the same time compare the relationship between the former two. Results: Of the 164 cases, benign lesions or no intraepithelial lesions were found in 164 cases, CINⅠ in 2 cases, CINⅡ / Ⅲ in 5 cases and cervical carcinoma in 1 case. TCT test results were 134 cases in the normal range, ASC-US was 25 cases, low-grade squamous intraepithelial lesion (LSIL) in 10 cases, high-grade squamous intraepithelial lesion (HSIL) in 3 cases. High-risk HPV-DNA test results were positive in 39 patients. The sensitivity of TCT was 94.34% (150/159), the specificity was 61.54% (8/13), the accuracy was 91.86% (158/172), and the positive predictive value was 97.77% (150/155). The negative predictive value However, the sensitivity of combined detection was 98.18% (162/165), the specificity was 85.71% (6/7) and the accuracy was 97.67% (168/172). The positive predictive value was 99.39% (162/163), the negative predictive value was 66.67% (6/9). Conclusion: Compared with TCT alone or high-risk HPV-DNA test, combined detection can effectively improve the positive rate of cervical precancerous lesions and reduce the rate of misdiagnosis, and then provide some reference for clinical diagnosis and treatment to ensure the life of female patients health and safety.