中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
35期
2503-2505
,共3页
徐兴云%赵蔚%李桂军%金小英%李永铮
徐興雲%趙蔚%李桂軍%金小英%李永錚
서흥운%조위%리계군%금소영%리영쟁
细胞学技术%人乳头瘤病毒%宫颈上皮内瘤样病变
細胞學技術%人乳頭瘤病毒%宮頸上皮內瘤樣病變
세포학기술%인유두류병독%궁경상피내류양병변
Cytological techniques%Human papillomavirus%Cervical intraepithelial neoplasia
目的 探讨液基薄层液基细胞学(TCT)、人乳头瘤病毒高危型杂交捕获(HR-HPV-HC2)联合检测筛查宫颈上皮内瘤样病变(CIN)及预警其术后复发临床价值.方法 对2009至2011年嘉兴市妇幼保健院的725例疑似CIN患者同时进行TCT、HR-HPV-HC2检测和多点锥切活组织检查确诊.对203例CINⅡ～Ⅲ级患者行宫颈leep术或冷刀锥切术,术后进行TCT、HR-HPV-HC2和多点锥切活检随访.分析TCT、HR-HPV-HC2单独和联合检测筛查CIN和预警其术后复发的灵敏度.结果 TCT、HC2单独检测初筛诊断CIN的漏诊率、误诊率分别为19.23％ (40/208)、12.50％( 12/96)和48.15％ (156/324)、74.07％( 240/324),敏感性、特异性分别为90.02％、97.01％和51.85％、17.76％.TCT、HC2联合检测满足其一即初筛诊断CIN的敏感性98.25％,漏诊率1.75％,阴性预测值89.70％；二者均需满足才能初筛诊断CIN的特异性58.95％,阳性预测值72.80％.TCT、HC2单独检测预警CIN术后6个月复发特异性80％左右；二者联合检测且均需满足才能诊断CIN术后复发,3个月特异性98.27％,6个月阴性预测值98.75％；二者联合检测且只需满足其一即诊断CIN术后复发的3、6个月敏感性均97.22％,6个月阴性预测值99.17％.结论 TCT、HC2联合检测,可明显提高CIN预警及术后复发的敏感性和特异性.
目的 探討液基薄層液基細胞學(TCT)、人乳頭瘤病毒高危型雜交捕穫(HR-HPV-HC2)聯閤檢測篩查宮頸上皮內瘤樣病變(CIN)及預警其術後複髮臨床價值.方法 對2009至2011年嘉興市婦幼保健院的725例疑似CIN患者同時進行TCT、HR-HPV-HC2檢測和多點錐切活組織檢查確診.對203例CINⅡ～Ⅲ級患者行宮頸leep術或冷刀錐切術,術後進行TCT、HR-HPV-HC2和多點錐切活檢隨訪.分析TCT、HR-HPV-HC2單獨和聯閤檢測篩查CIN和預警其術後複髮的靈敏度.結果 TCT、HC2單獨檢測初篩診斷CIN的漏診率、誤診率分彆為19.23％ (40/208)、12.50％( 12/96)和48.15％ (156/324)、74.07％( 240/324),敏感性、特異性分彆為90.02％、97.01％和51.85％、17.76％.TCT、HC2聯閤檢測滿足其一即初篩診斷CIN的敏感性98.25％,漏診率1.75％,陰性預測值89.70％；二者均需滿足纔能初篩診斷CIN的特異性58.95％,暘性預測值72.80％.TCT、HC2單獨檢測預警CIN術後6箇月複髮特異性80％左右；二者聯閤檢測且均需滿足纔能診斷CIN術後複髮,3箇月特異性98.27％,6箇月陰性預測值98.75％；二者聯閤檢測且隻需滿足其一即診斷CIN術後複髮的3、6箇月敏感性均97.22％,6箇月陰性預測值99.17％.結論 TCT、HC2聯閤檢測,可明顯提高CIN預警及術後複髮的敏感性和特異性.
목적 탐토액기박층액기세포학(TCT)、인유두류병독고위형잡교포획(HR-HPV-HC2)연합검측사사궁경상피내류양병변(CIN)급예경기술후복발림상개치.방법 대2009지2011년가흥시부유보건원적725례의사CIN환자동시진행TCT、HR-HPV-HC2검측화다점추절활조직검사학진.대203례CINⅡ～Ⅲ급환자행궁경leep술혹냉도추절술,술후진행TCT、HR-HPV-HC2화다점추절활검수방.분석TCT、HR-HPV-HC2단독화연합검측사사CIN화예경기술후복발적령민도.결과 TCT、HC2단독검측초사진단CIN적루진솔、오진솔분별위19.23％ (40/208)、12.50％( 12/96)화48.15％ (156/324)、74.07％( 240/324),민감성、특이성분별위90.02％、97.01％화51.85％、17.76％.TCT、HC2연합검측만족기일즉초사진단CIN적민감성98.25％,루진솔1.75％,음성예측치89.70％；이자균수만족재능초사진단CIN적특이성58.95％,양성예측치72.80％.TCT、HC2단독검측예경CIN술후6개월복발특이성80％좌우；이자연합검측차균수만족재능진단CIN술후복발,3개월특이성98.27％,6개월음성예측치98.75％；이자연합검측차지수만족기일즉진단CIN술후복발적3、6개월민감성균97.22％,6개월음성예측치99.17％.결론 TCT、HC2연합검측,가명현제고CIN예경급술후복발적민감성화특이성.
Objective To evaluate the clinical significance of combined detection of TCT and HR-HPV-HC2 assay in the screening and recurrence prediction of CIN.Methods A total of 725 patients with suspected cervical abnormalities received TCT plus HR-HPV-HC2 detection and histopathological examinations.203 CIN Ⅱ-Ⅲ patients received TCT and HC2 detection and histopathological examinations after treated with loop electrosurgical excision procedure or cold knife conization operation.The results of pathological examinations were gold standard.The sensitivity and specificity of TCT,HR-HPV-HC2 and TCT plus HR-HPV-HC2 were analyzed.Results The missed diagnosis and misdiagnosis rate of TCT and HC2 alone were 19.23％,12.50％ and 48.15％,74.07％ and sensitivity and specificity 90.02％,97.01％and 51.85％,17.76％ respectively.The sensitivity,missed diagnosis rate and negative predictive value were 98.25％,1.75％ and 89.70％ when TCT or HR-HPV-HC2 met the CIN diagnostic criteria.The specificity and positive predictive value were 58.95％ and 72.80％ when TCT and HR-HPV-HC2 met the CIN diagnostic criteria.The specificity of TCT or HR-HPV-HC2 alone was 80％ for the prediction of recurrence at Month 6 postoperation.The specificity of TCT plus HR-HPV-HC2 was 98.27％ for the prediction of recurrence at Month 3 postoperation and the negative predictive value was 98.75％ at Month 6 postoperation.The sensitivity of TCT or HR-HPV-HC2 was 97.22％ for the prediction of recurrence at Month 3/6.And the negative predictive value was 99.17％ at Month 6 postoperation.Conclusion The combined detection of TCT and HR-HPV-HC2 may improve the sensitivity and specificity of CIN and the predication of its postoperative recurrence.
