论文部分内容阅读
目的探讨肿瘤标志物检测联合人乳头瘤病毒脱氧核糖核酸(HPV DNA)检测与薄层液基细胞学检测(TCT检测)在诊断癌前病变及宫颈癌中的意义。方法选取40例子宫颈上皮内瘤变患者为A组、子宫颈癌患者20例为B组、50例健康体检者为C组。比较三组血清中糖类抗原15-3(CA15-3)、鳞状细胞癌抗原(SCCA)、角质蛋白19片段(CYFRA21-1)与CA125的水平;TCT检测各组研究对象,以病理活检诊断为金标准;比较各项检测阳性率和检测诊断宫颈癌的价值,并分析肿瘤标志物检测联合TCT检测与HPV DNA检测宫颈癌及癌前病变的临床价值。结果 B组各血清肿瘤标志物水平均高于C组,差异具有统计学意义(P<0.05)。HPV DNA检测阳性率均高于其他各单项检测阳性率,差异具有统计学意义(P<0.05);联合检测阳性率均高于各单项检测阳性率,差异具有统计学意义(P<0.05)。联合检测ROC曲线下面积为0.992,敏感性为91.67%,均高于各单项检测,差异有统计学意义(P<0.05)。结论宫颈癌的早期诊断与肿瘤标志物CA15-3、SCCA、CYFRA21-1与CA125的关系密切,联合TCT检测与HPV DNA检测相互结合以提高检出率,值得临床推广使用。
Objective To investigate the significance of detection of tumor markers combined with HPV DNA and TLCT in the diagnosis of precancerous lesions and cervical cancer. Methods Forty cases of cervical intraepithelial neoplasia were selected as group A, 20 cases of cervical cancer as group B, and 50 cases of healthy subjects as group C. The levels of carbohydrate antigen 15-3 (CA15-3), squamous cell carcinoma antigen (SCCA), keratin 19 fragment (CYFRA21-1) and CA125 were compared among the three groups. TCT was used to detect the levels of CA15-3, Diagnosed as gold standard; compare the positive rate of detection and the value of detecting and diagnosing cervical cancer, and analyze the clinical value of combining tumor marker detection with TCT detection and HPV DNA detection of cervical cancer and precancerous lesions. Results The serum tumor markers in group B were higher than those in group C, the difference was statistically significant (P <0.05). The positive rate of HPV DNA test was higher than that of other single test, the difference was statistically significant (P <0.05). The positive rate of HPV test was higher than the positive rate of each test (P <0.05). The area under the ROC curve of joint detection was 0.992, the sensitivity was 91.67%, which were all higher than those of single detection, the difference was statistically significant (P <0.05). Conclusion The early diagnosis of cervical cancer and tumor markers CA15-3, SCCA, CYFRA21-1 and CA125 are closely related to the combination of TCT detection and HPV DNA detection to improve the detection rate, worthy of clinical promotion and use.