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目的探讨液基薄层细胞学(TCT)技术联合人乳头状瘤病毒(HPV)检测在宫颈病变诊断中的价值。方法对2150例患者进行TCT和HPV检测,其中有1项或2项检测异常者同时进行阴道镜下活体组织检查,并以病理结果为金标准,比较两种方法及其联合检测的敏感度、特异度、诊断正确率、阳性预测值、阴性预测值。结果TCT检测阳性171例,敏感度95.9%,特异度56.5%,诊断正确率83.3%,阳性预测值82.5%,阴性预测值86.7%;HPV检测阳性178例,敏感度94.6%,特异度43.5%,诊断正确率78.2%,阳性预测值78.1%,阴性预测值78.9%;TCT和HPV联合检测阳性162例,敏感度98.6%,特异度75.4%,诊断正确率91.2%,阳性预测值89.5%,阴性预测值96.3%。TCT与HPV检测结果比较差异不显著(P>0.05),TCT或HPV检测结果与两种方法联合检测结果比较差异显著(P<0.05),联合检测的特异度和诊断正确率与上述一种方法比较差异显著(P<0.05)。结论 TCT与HPV检测是筛查宫颈病变的有效方法,两种方法联合应用可提高宫颈病变的诊断正确率和特异度。
Objective To investigate the value of liquid-based cytology (TCT) combined with human papillomavirus (HPV) detection in the diagnosis of cervical lesions. Methods TCT and HPV were detected in 2150 patients. One or two abnormalities were detected by colposcopy biopsy at the same time. The pathological results were taken as the gold standard. The sensitivity of the two methods and their combined detection were compared. Specificity, diagnostic accuracy, positive predictive value, negative predictive value. Results The positive results of TCT were 171 cases with sensitivity of 95.9% and specificity of 56.5%, diagnostic accuracy of 83.3%, positive predictive value of 82.5% and negative predictive value of 86.7%; HPV positive test of 178 cases, sensitivity of 94.6% and specificity of 43.5% , The diagnostic accuracy rate was 78.2%, the positive predictive value was 78.1%, the negative predictive value was 78.9%; 162 cases were positive for TCT and HPV, the sensitivity was 98.6%, the specificity was 75.4%, the diagnostic accuracy was 91.2%, the positive predictive value was 89.5% Negative predictive value 96.3%. TCT and HPV test results were not significantly different (P> 0.05), TCT or HPV test results combined with the two methods were significantly different (P <0.05), the specificity of the combined test and diagnostic accuracy with the above method The difference was significant (P <0.05). Conclusion TCT and HPV testing is an effective method for screening cervical lesions. The combination of the two methods can improve the diagnostic accuracy and specificity of cervical lesions.