中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2013年
2期
191-194
,共4页
王慧%王彤%胡尚英%赵方辉%张询%潘秦镜%章文华%李凌%乔友林
王慧%王彤%鬍尚英%趙方輝%張詢%潘秦鏡%章文華%李凌%喬友林
왕혜%왕동%호상영%조방휘%장순%반진경%장문화%리릉%교우림
宫颈肿瘤%筛检%人乳头瘤病毒%诊断试验%预测值
宮頸腫瘤%篩檢%人乳頭瘤病毒%診斷試驗%預測值
궁경종류%사검%인유두류병독%진단시험%예측치
Cervical neoplasia%Screening%Human papillomavirus%Binary diagnostic test%Predictive value
以病理组织学诊断为金标准,比较宫颈癌筛查中5%醋酸染色肉眼观察法(VIA)、薄层液基细胞学(LBC)、人乳头瘤病毒(HPV)自体采样法和HPV医生采样法的预测值.首先采用联合假设检验方法比较四种筛检方法的阳性预测值(PPV)和阴性预测值(NPV),并对两预测值进行组间两两比较,再采用边际回归法和加权最小二乘法分别比较该两预测值,多重性调整采用Hochberg法.结果表明HPV医生采样法的NPV最高,LBC的PPV最高,均为有效的宫颈癌初筛方法,但后者需要有经验的细胞病理学家读片.HPV自体采样法的PPV和NPV均高于VIA,其PPV与HPV医生采样法相当,NPV与LBC相当,因该方法易得到受检者配合而有可能提高筛查依从性,成为一种简便、客观、易于重复和适宜在资源贫乏地区使用的宫颈癌初筛方法.
以病理組織學診斷為金標準,比較宮頸癌篩查中5%醋痠染色肉眼觀察法(VIA)、薄層液基細胞學(LBC)、人乳頭瘤病毒(HPV)自體採樣法和HPV醫生採樣法的預測值.首先採用聯閤假設檢驗方法比較四種篩檢方法的暘性預測值(PPV)和陰性預測值(NPV),併對兩預測值進行組間兩兩比較,再採用邊際迴歸法和加權最小二乘法分彆比較該兩預測值,多重性調整採用Hochberg法.結果錶明HPV醫生採樣法的NPV最高,LBC的PPV最高,均為有效的宮頸癌初篩方法,但後者需要有經驗的細胞病理學傢讀片.HPV自體採樣法的PPV和NPV均高于VIA,其PPV與HPV醫生採樣法相噹,NPV與LBC相噹,因該方法易得到受檢者配閤而有可能提高篩查依從性,成為一種簡便、客觀、易于重複和適宜在資源貧乏地區使用的宮頸癌初篩方法.
이병리조직학진단위금표준,비교궁경암사사중5%작산염색육안관찰법(VIA)、박층액기세포학(LBC)、인유두류병독(HPV)자체채양법화HPV의생채양법적예측치.수선채용연합가설검험방법비교사충사검방법적양성예측치(PPV)화음성예측치(NPV),병대량예측치진행조간량량비교,재채용변제회귀법화가권최소이승법분별비교해량예측치,다중성조정채용Hochberg법.결과표명HPV의생채양법적NPV최고,LBC적PPV최고,균위유효적궁경암초사방법,단후자수요유경험적세포병이학가독편.HPV자체채양법적PPV화NPV균고우VIA,기PPV여HPV의생채양법상당,NPV여LBC상당,인해방법역득도수검자배합이유가능제고사사의종성,성위일충간편、객관、역우중복화괄의재자원빈핍지구사용적궁경암초사방법.
To compare the predictive values of 5% acetic acid stain and visual inspection,human papillomavirus (HPV) Self test,ThinPrep Pap and HPV direct test in screening for cervical cancer with biopsy as gold standard.Positive predictive values and negative predictive values were compared simultaneously by joint hypothesis tests and then either positive predictive values or negative predictive values of the any two screening tests were compared by marginal regression based on both GEE and weighted least square methods.Hochberg method was used for multiplicity adjustment.It was showed that HPV direct test had the highest negative predictive value and ThinPrep Pap the highest positive predictive value.5% acetic acid stain and visual inspection had both the lowest positive predictive value and negative predictive value.Both HPV direct test and ThinPrep Pap were efficient,but the latter required compatible infrastructure and skilled caregivers to go with.Both 5% acetic acid stain and visual inspection were inexpensive,and their positive predictive value and negative predictive value were lower than HPV self-test.They also had similar positive predictive value with HPV direct test and similar negative predictive value with ThinPrep Pap.HPV self-test appeared to be efficient,suggesting that it had significant potential for screening program to be implemented in the rural areas of China since the test could be performed without speculum examination in low-resource regions.
