论文部分内容阅读
目的:评价液基薄层细胞技术(TCT)、DNA倍体定量分析和HPV分型检测在宫颈癌和宫颈病变筛查诊断中的应用价值。方法:对武汉市17万农村妇女采用TCT、TBS诊断及DNA倍体定量分析筛查宫颈癌,对细胞学诊断高于低度鳞状上皮内病变或细胞DNA分析有≥3个异倍体细胞,建议做阴道镜下病理组织学活检并进行HPV检测。结果:以组织学诊断CINⅡ及以上级别病变作为评价两种筛查方法的标准,计算出TCT检查和DNA倍体定量分析及HPV检测方法的敏感度和特异度分别为68.35%、52.02%和81.40%、40.12%及92.18%、56.73%;阳性预期值和阴性预期值分别为35.18%、81.19%和35.30%、84.94%及45.47%、94.88%。结论:DNA倍体定量分析敏感度远远高于TCT检查,与TCT联合使用可以大大降低宫颈病变和宫颈癌的漏诊率;HPV检测与细胞学检查结合是宫颈癌最佳筛查方法,可最大限度地降低宫颈癌的漏诊率,提高筛查效率。
Objective: To evaluate the value of TCT, DNA ploidy quantitative analysis and HPV typing in the screening of cervical cancer and cervical lesions. Methods: 170,000 rural women in Wuhan were screened for cervical cancer by TCT, TBS diagnosis and DNA ploidy quantitative analysis. The results of cytological diagnosis were higher than those in low grade squamous intraepithelial lesions or ≥3 aneuploid cells , It is recommended to do colposcopy biopsy and HPV testing. Results: The sensitivity and specificity of TCT test, DNA ploidy quantitative analysis and HPV test were 68.35%, 52.02% and 81.40 respectively, which were based on histological diagnosis of CINⅡ and above lesions as the criteria for evaluating the two screening methods %, 40.12% and 92.18%, 56.73% respectively; the positive and negative expected values were 35.18%, 81.19% and 35.30%, 84.94% and 45.47% and 94.88% respectively. Conclusion: The sensitivity of DNA ploidy quantitative analysis is much higher than the TCT test, combined with TCT can greatly reduce the rate of misdiagnosis of cervical lesions and cervical cancer; HPV test combined with cytology is the best screening method for cervical cancer, which can be the largest Limit the rate of misdiagnosis of cervical cancer and improve the screening efficiency.