中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
1期
11-13
,共3页
王红琳%徐军%陆杲川%林晓%周红卫
王紅琳%徐軍%陸杲川%林曉%週紅衛
왕홍림%서군%륙고천%림효%주홍위
宫颈上皮内瘤变%人乳头瘤病毒%阴道镜检查%薄层液基细胞学检查
宮頸上皮內瘤變%人乳頭瘤病毒%陰道鏡檢查%薄層液基細胞學檢查
궁경상피내류변%인유두류병독%음도경검사%박층액기세포학검사
Cervical intraepithelial neoplasia%Human papillomavirus%Visual inspection%Thinprep cytologic test
目的 探讨人乳头瘤病毒DNA(HPV DNA)检测在宫颈癌及癌前病变诊治中的筛选价值.方法 我院妇科门诊宫颈疾病患者358例,均行宫颈薄层液基细胞学(TCT)检查、HPV DNA检测以及阴道镜检查并行多点活检,同时行高危型HPV DNA阳性检测,以宫颈病理诊断为金标准.结果 3种检测方法敏感度、特异度、准确率、阳性预测值、阴性预测值、约登指数依次为:HPV检测:81.40%、83.82%、82.24%、61.40%、93.44%、65.22%,TCT:66.28%、94.49%、87.71%、79.17%、89.86%、60.77%,阴道镜检测:72.62%、92.70%、87.99%、75.30%、91.70%、60.61%.HPV检测灵敏度最高为81.40%,阴道镜次之为72.62%,TCT检测最低为66.28%.HPV检测与TCT检测比较,差异有统计学意义(x~2=5.09,P<0.05),TCT检查为意义不明的不典型鳞状细胞如伴高危型HPV DNA阳性,宫颈活检阳性率为66.67%(16/24),高于高危型HPV DNA阴性的3.70%(1/27),差异有统计学意义(x~2=22.67,P<0.05).结论 HPV DNA检测宫颈病变敏感性高,综合评价效果较好.尤其对宫颈上皮内瘤变(CIN)Ⅱ以上阳性的检出率很高.而TCT检测特异度很高,对阴性预测较准,两者联合筛查结合阴道镜的辅助下进行病变区取材活检,能有效防止宫颈病变的漏诊和误诊,HPV DNA检测尤其对TCT检测为意义不明的不典型鳞状细胞的筛选更有意义.
目的 探討人乳頭瘤病毒DNA(HPV DNA)檢測在宮頸癌及癌前病變診治中的篩選價值.方法 我院婦科門診宮頸疾病患者358例,均行宮頸薄層液基細胞學(TCT)檢查、HPV DNA檢測以及陰道鏡檢查併行多點活檢,同時行高危型HPV DNA暘性檢測,以宮頸病理診斷為金標準.結果 3種檢測方法敏感度、特異度、準確率、暘性預測值、陰性預測值、約登指數依次為:HPV檢測:81.40%、83.82%、82.24%、61.40%、93.44%、65.22%,TCT:66.28%、94.49%、87.71%、79.17%、89.86%、60.77%,陰道鏡檢測:72.62%、92.70%、87.99%、75.30%、91.70%、60.61%.HPV檢測靈敏度最高為81.40%,陰道鏡次之為72.62%,TCT檢測最低為66.28%.HPV檢測與TCT檢測比較,差異有統計學意義(x~2=5.09,P<0.05),TCT檢查為意義不明的不典型鱗狀細胞如伴高危型HPV DNA暘性,宮頸活檢暘性率為66.67%(16/24),高于高危型HPV DNA陰性的3.70%(1/27),差異有統計學意義(x~2=22.67,P<0.05).結論 HPV DNA檢測宮頸病變敏感性高,綜閤評價效果較好.尤其對宮頸上皮內瘤變(CIN)Ⅱ以上暘性的檢齣率很高.而TCT檢測特異度很高,對陰性預測較準,兩者聯閤篩查結閤陰道鏡的輔助下進行病變區取材活檢,能有效防止宮頸病變的漏診和誤診,HPV DNA檢測尤其對TCT檢測為意義不明的不典型鱗狀細胞的篩選更有意義.
목적 탐토인유두류병독DNA(HPV DNA)검측재궁경암급암전병변진치중적사선개치.방법 아원부과문진궁경질병환자358례,균행궁경박층액기세포학(TCT)검사、HPV DNA검측이급음도경검사병행다점활검,동시행고위형HPV DNA양성검측,이궁경병리진단위금표준.결과 3충검측방법민감도、특이도、준학솔、양성예측치、음성예측치、약등지수의차위:HPV검측:81.40%、83.82%、82.24%、61.40%、93.44%、65.22%,TCT:66.28%、94.49%、87.71%、79.17%、89.86%、60.77%,음도경검측:72.62%、92.70%、87.99%、75.30%、91.70%、60.61%.HPV검측령민도최고위81.40%,음도경차지위72.62%,TCT검측최저위66.28%.HPV검측여TCT검측비교,차이유통계학의의(x~2=5.09,P<0.05),TCT검사위의의불명적불전형린상세포여반고위형HPV DNA양성,궁경활검양성솔위66.67%(16/24),고우고위형HPV DNA음성적3.70%(1/27),차이유통계학의의(x~2=22.67,P<0.05).결론 HPV DNA검측궁경병변민감성고,종합평개효과교호.우기대궁경상피내류변(CIN)Ⅱ이상양성적검출솔흔고.이TCT검측특이도흔고,대음성예측교준,량자연합사사결합음도경적보조하진행병변구취재활검,능유효방지궁경병변적루진화오진,HPV DNA검측우기대TCT검측위의의불명적불전형린상세포적사선경유의의.
Objective To assess human papillomavirus(HPV)detection method in screening cervical intra-epithelial neoplasia and cervical cancer.Methods Totally 358 clinical cases were enrolled.Three screening methods included HPV DNA testing,thinprep cytologic test(TCT)and multiple punch biopsy by colposcopy.The pathology results were regarded as gold standard.Results The sensitivity(Se),specificity(Sp),efficiency(E),positive predictive value(PV+),negative predictive value(PV-),Youden,s index(Y)value of each diagnostic test were:TCT(66.28%,94.49%,87.71%,79.17%,89.86%,60.77%),HPV DNA testing(81.40%,83.82%,82.24%,61.40%,93.44%,65.22%),colposcopic evaluation(72.62%,92.70%,87.99%,75.30%,91.70%,60.61%).The sensitivity of HPV DNA testing was the highest(81.40%)and TCT was the lowest(66.28%).There was a statistically significant diffierence between HPV DNA testing and TCT(P<0.05).Conclusions HPV DNA testing has a very high sensitivity for the detection of CINⅡ.TCT has a high specificity.which can reduce the misdiagnosis rate and omission diagnostic rate by combining the colposcopic evaluation and biopsy test.HPV method is a good mothod of screening ASCUS.
