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目的探讨超薄液基细胞学(TCT)和高危人乳头瘤病毒DNA聚合酶链反应(HR-HPV DNA PCR)检测在宫颈癌及其癌前病变筛选中的价值。方法选取2008年2月至2013年2月查体女工中拟诊宫颈癌需要进行病理活检的480例患者进行TCT和HR-HPV DNA PCR检测,并与病理结果对照,比较TCT、HR-HPV DNA PCR及其联合检测的特异度、灵敏度、阳性预测值、阴性预测值和准确度。结果 TCT、HR-HPV DNA PCR及其联合检测的特异度分别为65.6%、58.8%和92.1%,灵敏度分别为75.4%、85.7%和69.5%,阳性预测值分别为56.6%、44.6%和65.8%,阴性预测值分别为86.8%、85.4%和88.9%,准确度分别为73.4%、60.4%和81.2%。HR-HPV DNA PCR的灵敏度显著高于TCT和联合检测(P<0.05),联合检测的特异度、准确度均显著高于TCT和HR-HPV DNA PCR(P<0.05),TCT和HR-HPV DNA PCR的阳性预测值显著低于联合检测(P<0.05),三者阴性预测值差异无统计学意义(P>0.05)。结论 TCT、HR-HPV DNA PCR均能有效筛选宫颈癌及其癌前病变,而联合检测则能使两种检查优势互补,提高诊断的准确度。
Objective To investigate the value of ultra-thin liquid-based cytology (TCT) and high-risk human papillomavirus DNA polymerase chain reaction (HR-HPV DNA PCR) in the screening of cervical cancer and precancerous lesions. Methods The TCT and HR-HPV DNA PCR were detected in 480 patients with pathological biopsy who were diagnosed with cervical cancer from February 2008 to February 2013. The TCT and HR-HPV DNA were compared with the pathological results PCR and its combined detection of specificity, sensitivity, positive predictive value, negative predictive value and accuracy. Results The specificities of TCT, HR-HPV DNA PCR and their combined detection were 65.6%, 58.8% and 92.1% respectively, with sensitivity of 75.4%, 85.7% and 69.5%, respectively, and the positive predictive values were 56.6%, 44.6% and 65.8 % And negative predictive value were 86.8%, 85.4% and 88.9% respectively, with the accuracy of 73.4%, 60.4% and 81.2% respectively. The sensitivity of HR-HPV DNA PCR was significantly higher than that of TCT and combined detection (P <0.05). The specificity and accuracy of combined detection were significantly higher than that of TCT and HR-HPV DNA PCR (P <0.05) The positive predictive value of DNA PCR was significantly lower than that of the combined test (P <0.05), but there was no significant difference between the three predictive values (P> 0.05). Conclusion Both TCT and HR-HPV DNA PCR can effectively screen cervical cancer and precancerous lesions, while combined detection can complement each other and improve the diagnostic accuracy.