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目的研究超薄液基细胞学检测(TCT)和第二代双基因杂交捕获-高危HPV DNA检测法(HC2-HPVDNA)在宫颈癌早期病变及癌前病变患者中的筛查效果。方法选择进行宫颈病变筛查的5000例患者。采用TCT和HC2-HPV-DNA法对患者进行筛查,再与宫颈活检病理学结果进行对比,分析TCT、HC2-HPV-DNA和TCT+HC2-HPV-DNA的敏感度、特异度、阳性预测值和阴性预测值。结果 TCT和HC2-HPV-DNA检测结果与病理组织学结果相比有一定的差异,病理组织学结果≥CINⅠ为阳性者414例,占总检测例数的8.28%;TCT检查≥ASCUS为阳性者409例,占总检测例数的8.18%;HC2-HPV-DNA阳性者499例,占总检测例数的9.98%。TCT+HC2-HPV-DNA联合检测的敏感度(99.28%)高于HC2-HPV-DNA(52.42%)、TCT(45.65%)单项检测的敏感度(P﹤0.05)。而TCT+HC2-HPV-DNA联合检测的阳性预测值(82.36%),高于TCT(46.21%)、HC2-HPV-DNA单项检测的阳性预测值(43.49%)(P﹤0.05)。结论 TCT联合HC2-HPV-DNA筛查可以明显提高宫颈癌早期及癌前病变诊断的敏感度和阳性预测值,值得在临床推广应用。
Objective To investigate the screening results of ultrathin liquid-based cytology (TCT) and second generation double-gene hybridization-high-risk HPV DNA detection (HC2-HPVDNA) in patients with cervical precancerous lesions and precancerous lesions. Methods 5000 patients with cervical lesions were selected. The patients were screened by TCT and HC2-HPV-DNA and compared with the results of cervical biopsy. The sensitivity, specificity and positive predictive value of TCT, HC2-HPV-DNA and TCT + HC2-HPV- Value and negative predictive value. Results The results of TCT and HC2-HPV-DNA were different from the results of histopathological examination. There were 414 histopathological positive results in CINⅠ, accounting for 8.28% of the total cases. TCT and ≥ASCUS were positive 409 cases, accounting for 8.18% of the total test cases; 499 HC2-HPV-DNA positive cases, accounting for 9.98% of the total test cases. The sensitivity of combined detection of TCT + HC2-HPV-DNA (99.28%) was higher than that of HC2-HPV-DNA (52.42%) and TCT (45.65%) alone (P <0.05). The positive predictive value of TCT + HC2-HPV-DNA was 82.36%, higher than that of TCT (46.21%), and the positive predictive value of HC2-HPV-DNA was 43.49% (P <0.05). Conclusion TCT combined with HC2-HPV-DNA screening can significantly improve the sensitivity and positive predictive value of early diagnosis and precancerous lesions of cervical cancer, which is worthy of clinical application.