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目的探讨液基细胞学检查联合DNA定量分析在女性宫颈上皮内病变筛查中的应用价值。方法选取2013年1月-2016年12月在医院妇科门诊接受宫颈筛查疑似宫颈上皮内病变的患者500例作为研究对象,所有患者均接受液基细胞学检查、宫颈脱落细胞DNA定量分析,以宫颈病理组织学活检诊断结果为金标准,比较联合检查与单项检查对宫颈上皮内病变的诊断敏感度、特异度及Youden指数。结果 500例疑似宫颈病变患者中,经宫颈病理组织学活检诊断证实为宫颈上皮内病变373例。联合检查对宫颈上皮内病变的筛查敏感度明显高于单项检查(P<0.05),但特异度与单项检查差异无统计学意义(P>0.05),且联合检查的Youden指数较高。结论液基细胞学检查联合宫颈脱落细胞DNA定量分析应用于宫颈上皮内病变筛查中具有较高的诊断敏感度,有利于减少宫颈上皮内病变的漏诊。
Objective To investigate the value of liquid-based cytology combined with DNA quantitative analysis in the screening of cervical intraepithelial lesions in women. METHODS: From January 2013 to December 2016, 500 patients with cervical intraepithelial lesions suspected to undergo cervical screening in gynecology outpatient department of the hospital were enrolled in this study. All patients underwent liquid-based cytology and quantitative DNA analysis of cervical exfoliated cells. Cervical pathological biopsy diagnostic results for the gold standard, a combination of examination and single examination of cervical intraepithelial lesions diagnostic sensitivity, specificity and Youden index. Results Among the 500 cases of suspected cervical lesions, 373 cases of cervical intraepithelial lesions were diagnosed by cervical histopathological biopsy. The screening sensitivity of combined examination for cervical intraepithelial lesion was significantly higher than that of single examination (P <0.05), but there was no significant difference between specificity and single examination (P> 0.05). The Youden index of combined examination was higher. Conclusion Liquid-based cytology combined with cervical exfoliated cells DNA quantitative analysis of cervical intraepithelial lesions screening has a high diagnostic sensitivity, is conducive to reducing the misdiagnosis of cervical intraepithelial lesions.