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目的评估人乳头瘤病毒(Human papillomavirus,HPV)16感染和液基薄层细胞学(thinprep cytologic test,TCT)筛查在预测宫颈病变中的临床价值。方法以门诊537例高危型HPV感染疑似宫颈病变女性为对象,进行HPV16感染分析、液基薄层细胞学和阴道镜病理检查,以病理活检为金标准,比较HPV16感染筛查方法、TCT筛查方法以及二者联用在筛查中的敏感度、特异度等指标,判断其临床应用价值。结果 HPV16感染筛查方法的敏感度为62.9%,特异度为83.5%,阳性预测值为53.4%,阴性预测值为88.2%;TCT筛查方法的敏感度为41.2%,特异度为92.7%,阳性预测值为62.9%,阴性预测值为84.0%;二者联合筛查,以HPV16感染或TCT异常为阳性,敏感度为84.7%,特异度为75.8%,阳性预测值为51.2%,阴性预测值为94.3%。结论 HPV16感染联合TCT异常筛查可以提高筛查的灵敏度,特异度也在可接受范围内,可以作为宫颈防癌初筛方法。
Objective To evaluate the clinical value of human papillomavirus (HPV) 16 infection and thinprep cytologic test (TCT) in predicting cervical lesions. Methods A total of 537 high-risk HPV-positive women with cervical lesions were selected as the target for HPV16 infection, thin-layer cytology and colposcopy pathology. The pathological biopsy was taken as the gold standard. The HPV16 infection screening methods, TCT screening Methods and the combination of the two in screening sensitivity, specificity and other indicators to determine its clinical value. Results The sensitivity of HPV16 screening method was 62.9%, the specificity was 83.5%, the positive predictive value was 53.4% and the negative predictive value was 88.2%. The sensitivity and specificity of TCT screening method were 41.2% and 92.7% The positive predictive value was 62.9%, the negative predictive value was 84.0%. The combined screening of HPV16 infection and TCT was positive, with a sensitivity of 84.7%, a specificity of 75.8% and a positive predictive value of 51.2%. Negative predictive value The value is 94.3%. Conclusion HPV16 infection combined with TCT abnormal screening can improve the sensitivity of screening, specificity is within acceptable range, and can be used as a screening method for cervical cancer prevention.