易驰喆, 陆妹英, 苏讷敏, 李菲凡, 以敏. 人乳头瘤病毒分型联合宫颈液基薄层细胞学检测在宫颈癌筛查中的应用[J]. 上海预防医学, 2022, 34(1): 73-76. DOI: 10.19428/j.cnki.sjpm.2022.21097
引用本文: 易驰喆, 陆妹英, 苏讷敏, 李菲凡, 以敏. 人乳头瘤病毒分型联合宫颈液基薄层细胞学检测在宫颈癌筛查中的应用[J]. 上海预防医学, 2022, 34(1): 73-76. DOI: 10.19428/j.cnki.sjpm.2022.21097
YI Chizhe, LU Meiying, SU Nemin, LI Feifan, YI Min. Clinical application value of human papillomavirus typing combined with cervical thin-prep cytology test in cervical cancer screening[J]. Shanghai Journal of Preventive Medicine, 2022, 34(1): 73-76. DOI: 10.19428/j.cnki.sjpm.2022.21097
Citation: YI Chizhe, LU Meiying, SU Nemin, LI Feifan, YI Min. Clinical application value of human papillomavirus typing combined with cervical thin-prep cytology test in cervical cancer screening[J]. Shanghai Journal of Preventive Medicine, 2022, 34(1): 73-76. DOI: 10.19428/j.cnki.sjpm.2022.21097

人乳头瘤病毒分型联合宫颈液基薄层细胞学检测在宫颈癌筛查中的应用

Clinical application value of human papillomavirus typing combined with cervical thin-prep cytology test in cervical cancer screening

  • 摘要:
    目的 探讨第三代人乳头状瘤病毒核酸检测杂交捕获定量分型技术(DH3)分型检测人乳头瘤病毒(HPV)联合宫颈液基薄层细胞学检查(TCT)在宫颈癌筛查中的应用价值。
    方法 选择2020年10月—2021年3月在广西医科大学第四附属医院柳州市工人医院进行HPV分型和TCT宫颈筛查的女性患者进行回顾性分析,共1 582例,以病理学检查结果为金标准,对结果进行分析比较。
    结果 在 1 582例患者中,HPV检测结果阳性334例,阴性1 248例;TCT检测结果阳性234例,阴性1 348例;病理学检查结果阳性180例,阴性 1 402例。HPV分型联合TCT检测中,极度高危型和高危型HPV双重阳性检测结果与病理检查结果无差异,其他HPV单一分型阳性检测结果与病理检查结果有差异,分别检出TCT漏诊病例。HPV分型检测的灵敏度为100.0%,阳性预测值为53.9%,特异度为89.0%,阴性预测值为100.0%。HPV分型检测中,高危型HPV16和18的阳性预测值高达94.8%,其他12种高危型HPV的阳性预测值为73.8%,低级别鳞状上皮内病变诊断病例稍有偏差,高级别鳞状上皮内病变与鳞状上皮癌的诊断基本一致。
    结论 HPV分型联合TCT筛查宫颈癌可降低单项检查的误诊率和漏诊率,HPV分型检测有助于对患者进行分层管理,对检查分流和级别筛查具有较高的临床应用价值。

     

    Abstract:
    Objective To explore the clinical value of the third-generation hybrid capture nucleic acid detection technology (DH3) typing detection of human papillomavirus (HPV) combined with thin-prep cytology test (TCT) in screening cervical cancer.
    Methods A total of 1 582 female patients who received HPV and TCT cervical screening in Liuzhou Workers Hospital, Fourth Affiliated Hospital of Guangxi Medical University, from October 2020 to March 2021, were selected for this retrospective analysis. The cervical histopathological diagnosis was used as the gold standard to evaluate the diagnosis accuracies of HPV and TCT test results.
    Results Among the 1 582 patients, 334 were positive for HPV and 1 248 were negative; 234 were positive for TCT and 1 348 were negative; 180 were positive for histopathological diagnostic and 1 402 were negative. The sensitivity of HPV detection was 100%, the positive predictive value was 53.9%, the specificity was 89.0%, and the negative predictive value was 100.0%. In the HPV typing test, the positive rate for high-risk types 16/18 was 94.8%, and the positive rate for other 12 high-risk types was 73.8%. There was a little difference between TCT test and pathological test, and the detection consistency rate of high-grade squamous intraepithelial lesions and squamous carcinoma was same.
    Conclusion HPV testing combined with TCT to screen cervical cancer can reduce the misdiagnosis rate by a single test. The classification test is helpful for the hierarchical management of patients, and has a high clinical value for examination triage and grade screening.

     

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