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目的探讨人乳头瘤病毒(HPV)分型检测在早期宫颈癌患者中的诊断价值。方法选取2015年1月-2016年12月在中国人民解放军第105医院妇产科进行宫颈癌筛查的547例女性患者为研究对象,分别比较早期宫颈癌患者HPV感染分型及PCR、液基薄层细胞检测(TCT)及联合检测对早期宫颈癌的诊断价值,并分析PCR、TCT及联合检测的诊断价值。结果共检出HPV感染患者114例,检出率为20.84%;其中单一感染患者100例,检出率为18.28%,构成比为87.72%,多重感染患者14例,检出率为2.56%,构成比为12.28%。早期宫颈癌患者HPV感染分型检出率排前3位的是HPV 16(30.70%)、HPV 52(14.04%)、HPV 18(7.89%)。TCT诊断灵敏度为66.25%(53/80),特异度为55.67%(260/467),准确性为57.22%;PCR诊断灵敏度为87.72%(100/114),特异度90.99%(394/433),准确性为90.31%;PCR和TCT联合检测诊断灵敏度为97.00%(97/100),特异度为95.97%(429/447),准确性为96.16%。PCR和TCT联合检测灵敏度、特异度及准确性明显高于单一检测,差异均有统计学意义(P<0.05)。结论 PCR反向点杂交和TCT联合检测可明显提高宫颈癌诊断的准确性。
Objective To investigate the diagnostic value of human papillomavirus (HPV) typing in early cervical cancer patients. Methods A total of 547 female patients with cervical cancer screening in the Department of Obstetrics and Gynecology, 105th Hospital of PLA from January 2015 to December 2016 were selected as study subjects. HPV types, PCR, (TCT) and combined detection of early diagnosis of cervical cancer, and analyze the diagnostic value of PCR, TCT and combined detection. Results A total of 114 cases of HPV infection were detected, the detection rate was 20.84%. Among them, 100 cases of single infection were detected with the detection rate of 18.28%, the constituent ratio of 87.72% and the multiple infection of 14 cases with the detection rate of 2.56% The composition ratio is 12.28%. In the first three cases, HPV16 (30.70%), HPV 52 (14.04%) and HPV18 (7.89%) were detected in the top three cervical cancer patients. The diagnostic sensitivity of TCT was 66.25% (53/80), the specificity was 55.67% (260/467), the accuracy was 57.22%. The diagnostic sensitivity of TCT was 87.72% (100/114) and the specificity was 90.99% (394/433) , The accuracy was 90.31%. The diagnostic sensitivity of PCR and TCT was 97.00% (97/100), the specificity was 95.97% (429/447) and the accuracy was 96.16%. The sensitivity, specificity and accuracy of PCR and TCT were significantly higher than those of single test (P <0.05). Conclusion PCR reverse hybridization and TCT combined detection can significantly improve the diagnostic accuracy of cervical cancer.