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目的观察并评价薄层液基细胞学技术(TCT)、二代杂交捕获技术(HC2)及阴道镜联合检查在宫颈疾病筛查中的应用价值。方法选择2015年2月至2016年12月期间就诊东莞市第八人民医院妇科门诊238名患者,同时给予TCT、HC2、阴道镜检查、并在阴道镜下采取活组织检查,以病理为金标准,分析和评价子宫颈癌及癌前病变三种筛查方法。结果 238例患者中,病理阳性(宫颈上皮瘤变Ⅰ、Ⅱ、Ⅲ,宫颈癌)为118例占49.58%(118/238),在宫颈疾病的诊断中敏感度从高到低依次为HC2检测(100.00%)、阴道镜检查(95.24%)、TCT检测(85.71%),但三者之间差异均无统计学意义(P>0.05),HC2与TCT敏感度相比较差异有统计学意义(χ~2=8.357,P<0.05),阴道镜与TCT、HC2敏感度相比较差异无统计学意义(χ~2=2.205,P>0.05),TCT、HC2及阴道镜联合检出114例,同TCT敏感度比较差异有统计学意义(χ~2=28.875,P<0.05),同HC2敏感度比较差异有统计学意义(χ~2=7.983,P<0.05),同阴道镜敏感度比较差异有统计学意义(χ~2=17.251,P<0.05)。结论 TCT、HC2检测、阴道镜检查在宫颈疾病筛查中各有其特点及优势,三者联合使用,能够显著地提高宫颈疾病的检出率,降低漏诊率,联合筛查优于单独使用一种检测方法进行宫颈疾病筛查,值得在临床推广应用。
Objective To observe and evaluate the value of TCT, HC2 and colposcopy in the screening of cervical diseases. Methods A total of 238 gynecological patients from the Eighth People’s Hospital of Dongguan City from February 2015 to December 2016 were selected. TCT, HC2, colposcopy and biopsy under colposcopy were performed. The pathology was taken as the gold standard , Analysis and evaluation of cervical cancer and precancerous lesions of the three screening methods. Results Of the 238 patients, 118 (49.58%) showed pathological positive results (cervical epithelial neoplasia Ⅰ, Ⅱ, Ⅲ, cervical cancer). The sensitivity of cervical cancer in the diagnosis of cervical disease was HC2 (100.00%), colposcopy (95.24%) and TCT (85.71%), but there was no significant difference among them (P> 0.05). There was significant difference between HCT and TCT sensitivities There was no significant difference between colposcopy and TCT, HC2 sensitivity (χ ~ 2 = 2.205, P> 0.05). There were 114 cases detected by TCT, HC2 and colposcopy, The sensitivity to TCT was significantly different from that of TCT (χ ~ 2 = 28.875, P <0.05), and the sensitivity to HC2 was statistically significant (χ ~ 2 = 7.983, P <0.05) The difference was statistically significant (χ ~ 2 = 17.251, P <0.05). Conclusion TCT, HC2 test and colposcopy have their own characteristics and advantages in cervical disease screening. The combination of the three can significantly improve the detection rate of cervical disease and reduce the rate of misdiagnosis, and the combined screening is superior to that of single use Cervical disease screening test methods, it is worth in the clinical application.