论文部分内容阅读
目的评价人乳头状瘤病毒(HPV)DNA检测在宫颈癌筛查中的价值。方法采用第二代杂交捕获(HC-Ⅱ)技术和液基细胞学测试(LCT)2种方法 ,对1026例在妇科病中心就诊的受检者进行同步盲法检测,同时进行阴道镜检查。以宫颈活检组织病理学检查结果为诊断标准。评价该方案在宫颈癌筛查中的应用价值。结果病理检查结果显示,宫颈上皮内瘤变(CIN)-Ⅰ级152例,CIN-Ⅱ级108例,CIN-Ⅲ级109例,宫颈浸润癌28例。筛查高危型HPV感染366例,阳性率35.70%,在不同宫颈病变中的阳性率分别是:宫颈癌92.90%(26/28),CIN-Ⅲ90.0%(99/109),CIN-Ⅱ88.90%(96/108),CIN-Ⅰ87.50%(133/152)。高危HPV对宫颈高级别病变的敏感性、特异性、阳性预测值,阴性预测值分别是98.60%、86.10%、14.80%和99.80%;HPV与LCT联合检测(平行试验)的以上各指标分别是100.00%、80.90%、12.10%和100.00%。结论高危型人乳头状瘤病毒检测在宫颈癌前病变的筛查中有较高的敏感度和阴性预测值,联合LCT检测是目前宫颈癌筛查具有诊断价值的方法 。
Objective To evaluate the value of human papillomavirus (HPV) DNA testing in cervical cancer screening. Methods The second generation hybridization capture (HC-Ⅱ) technique and liquid-based cytology test (LCT) were used to detect 1026 subjects who were treated in gynecological center simultaneously and colposcopy. Cervical biopsy histopathological examination as a diagnostic criteria. Evaluation of the program in cervical cancer screening value. Results The pathological results showed that 152 cases of cervical intraepithelial neoplasia (CIN) -Ⅰ, 108 cases of CIN-Ⅱ, 109 cases of CIN-Ⅲ and 28 cases of invasive cervical carcinoma. The positive rates of cervical cancer were 92.90% (26/28), 90.0% (99/109) of CIN-Ⅲ, and CIN-Ⅱ88 were positive in screening 366 cases of high-risk HPV infection, the positive rate was 35.70% .90% (96/108), CIN-I87.50% (133/152). The sensitivity, specificity, positive predictive value and negative predictive value of high risk HPV were 98.60%, 86.10%, 14.80% and 99.80% respectively. The above indexes of HPV and LCT combined test (parallel test) were 100.00%, 80.90%, 12.10% and 100.00%. Conclusions High-risk human papillomavirus (HPV) detection has higher sensitivity and negative predictive value in the screening of cervical precancerous lesions. Combined with LCT detection is the diagnostic value of cervical cancer screening.