高危型HPV检测及TCT检查在宫颈癌筛查中的应用分析
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摘要
目的分析高危型HPV和TCT检查在宫颈癌筛查中的应用价值。方法回顾性分析2014年5月—2016年5月在该院做宫颈癌筛查的85例患者,均具有病理检查结果的行高危型HPV检测和TCT检查数据,观察高危型HPV检测和TCT检查在宫颈癌筛查中的灵敏度、特异度和高危型HPV病毒载量与宫颈病变程度的关系。结果患者病理检查结果为55例为阴性,30例为阳性;高危型HPV检测所有患者均为阳性;TCT检查75例为阴性、10例为阳性,其中5例病理检查结果为炎性和CINⅠ。CINⅡ及以上患者30例;30例患者高危型HPV检测均为阳性;TCT检测异常10例,其中有5例病理检查结果为CINⅡ以上病变。高危型HPV检测灵敏度为100.0%, TCT灵敏度为16.7%,两种检测方法对比,差异具有统计学意义(P <0.05);HPV特异度为0.0%,TCT特异度为90.9%,差异具有统计学意义(P <0.05)。高危型HPV病毒载量越多,宫颈病变程度越重。结论 HPV检测灵敏度高、特异度低,而TCT检查灵敏度低、特异度高,临床上可两者联合应用于宫颈癌筛查;高危型HPV病毒载量对于预测宫颈病变具有重要价值。
Objective The clinical value of high-risk HPV detection and TCT examination in the cervical cancer screening. Methods A retrospective analysis of 85 patients who underwent the cervical cancer screening from May 2014 to May 2016 was performed with high-risk HPV and TCT data for pathological examination. High-risk HPV and TCT were observed. Sensitivity, specificity, and relationship between high-risk HPV viral load and cervical lesions in cervical cancer screening. Results The pathological examination results showed that 55 cases were negative and 30 cases were positive; all patients with high-risk HPV test were positive; 75 cases were negative and 10 cases were positive by TCT, and 5 cases were pathologically inflammatory and CINI. 30 patients with CINII and above; 30 patients with high-risk HPV test were positive; 10 patients with abnormal TCT, including 5 cases of pathological examination for CINII and above. The high-risk HPV detection sensitivity was 100.0%, and the TCT sensitivity was 16.7%. There was a statistically significant difference between the two detection methods(P < 0.05); HPV specificity was 0.0%, and TCT specificity was 90.9%, the difference was statistically significant(P < 0.05). The higher the load of high-risk HPV virus, the more severe the cervical lesions. Conclusion HPV has high sensitivity and low specificity, while TCT has low sensitivity and high specificity. It can be used in cervical cancer screening in combination. High-risk HPV viral load is of great value in predicting cervical lesions.
Objective The clinical value of high-risk HPV detection and TCT examination in the cervical cancer screening. Methods A retrospective analysis of 85 patients who underwent the cervical cancer screening from May 2014 to May 2016 was performed with high-risk HPV and TCT data for pathological examination. High-risk HPV and TCT were observed. Sensitivity, specificity, and relationship between high-risk HPV viral load and cervical lesions in cervical cancer screening. Results The pathological examination results showed that 55 cases were negative and 30 cases were positive; all patients with high-risk HPV test were positive; 75 cases were negative and 10 cases were positive by TCT, and 5 cases were pathologically inflammatory and CINI. 30 patients with CINII and above; 30 patients with high-risk HPV test were positive; 10 patients with abnormal TCT, including 5 cases of pathological examination for CINII and above. The high-risk HPV detection sensitivity was 100.0%, and the TCT sensitivity was 16.7%. There was a statistically significant difference between the two detection methods(P < 0.05); HPV specificity was 0.0%, and TCT specificity was 90.9%, the difference was statistically significant(P < 0.05). The higher the load of high-risk HPV virus, the more severe the cervical lesions. Conclusion HPV has high sensitivity and low specificity, while TCT has low sensitivity and high specificity. It can be used in cervical cancer screening in combination. High-risk HPV viral load is of great value in predicting cervical lesions.
引文
[1]陈春林.中国宫颈癌临床诊疗与大数据[J].中国实用妇科与产科杂志,2018,34(1):25-29.
[2]American College of Obstetricians and Gynecologists. Practice bulletin no. 157:cervical cancer screening and prevention[J]. Obstet Gynecol,2016,127(1):e1-e20.
[3]廖婷,方云香,彭薇颖.宫颈癌常用筛选技术比较和应用研究[J].中外医学研究,2014,12(5):59-60.
[4]许剑利,徐克惠.高危型HPV检测及TCT检查在宫颈癌筛查中的应用分析[J].实用妇产科杂志,2014,30(12):946-949.
[5]井佳雨,牟婧祎,王轶英,等.宫颈癌及癌前病变筛查方法研究进展[J].中华实用诊断与治疗杂志,2017,31(2):203-205.
[6]Quddus MR,Manna P,Sung CJ,et al. Prevalence, distribu-tion,and viral burden of all 15 high-risk human papillo-mavirus types in adenosquamous carcinoma of the uterine cervix:a multiplex realtime polymerase chain reaction-based study[J]. Hum Pathol,2014,45(2):303-309.
[7]吴瑞芳,杜辉.建立以HPV检测为基础的自取样子宫颈癌筛查模式的探讨[J].中华妇产科杂志,2017,52(9):582-585.
[8]Wright TC,Stoler MH,Behrens CM,et al. Primary cervical cancer screening with human papillomavirus:end of study results from the athena study using hpv as the first-line screening test[J]. Gynecol Oncol,2015,136(2):189-197.
[9]魏丽惠.从不同视角看以HPV检测作为宫颈癌初筛的方法[J].中国妇产科临床杂志,2016,17(1):1-2.
[10]赵文霞,茅彩英,朱向宇,等. HPV与TCT联合作为宫颈癌初筛的临床意义[J].中国妇幼保健,2014,29(2):187-189.
[2]American College of Obstetricians and Gynecologists. Practice bulletin no. 157:cervical cancer screening and prevention[J]. Obstet Gynecol,2016,127(1):e1-e20.
[3]廖婷,方云香,彭薇颖.宫颈癌常用筛选技术比较和应用研究[J].中外医学研究,2014,12(5):59-60.
[4]许剑利,徐克惠.高危型HPV检测及TCT检查在宫颈癌筛查中的应用分析[J].实用妇产科杂志,2014,30(12):946-949.
[5]井佳雨,牟婧祎,王轶英,等.宫颈癌及癌前病变筛查方法研究进展[J].中华实用诊断与治疗杂志,2017,31(2):203-205.
[6]Quddus MR,Manna P,Sung CJ,et al. Prevalence, distribu-tion,and viral burden of all 15 high-risk human papillo-mavirus types in adenosquamous carcinoma of the uterine cervix:a multiplex realtime polymerase chain reaction-based study[J]. Hum Pathol,2014,45(2):303-309.
[7]吴瑞芳,杜辉.建立以HPV检测为基础的自取样子宫颈癌筛查模式的探讨[J].中华妇产科杂志,2017,52(9):582-585.
[8]Wright TC,Stoler MH,Behrens CM,et al. Primary cervical cancer screening with human papillomavirus:end of study results from the athena study using hpv as the first-line screening test[J]. Gynecol Oncol,2015,136(2):189-197.
[9]魏丽惠.从不同视角看以HPV检测作为宫颈癌初筛的方法[J].中国妇产科临床杂志,2016,17(1):1-2.
[10]赵文霞,茅彩英,朱向宇,等. HPV与TCT联合作为宫颈癌初筛的临床意义[J].中国妇幼保健,2014,29(2):187-189.