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目的评价薄层液基细胞学(Thinprep Cytology Test,TCT)与高危型人乳头瘤病毒(human papilloma-virus,HR-HPV)检测在宫颈上皮病变筛查中的应用价值。方法对广东省潮州市3723名农村妇女同时进行TCT检查和HR-HPV检测,阳性的妇女进行宫颈组织病理学检查,分析TCT与HR-HPV检测以及联合检查在宫颈上皮病变筛查中的应用价值。结果 78例农村妇女TCT检查阳性,其中鳞状细胞(ASC)15例(19.2%);低级别鳞状上皮病变(LSIL)44例(56.4%);高级别鳞状上皮病变(HSIL)19例(24.4%)。65例检测出HR-HPV阳性,阳性率为1.7%(65/3723)。94例患者宫颈组织病理诊断为炎症者19例(20.2%);宫颈上皮内瘤样病变(CIN)Ⅰ级39例(41.5%)、CINⅡ级15例(16.0%)、CINⅢ级20例(21.3%);鳞状细胞癌(SCC)1例(1.1%)。TCT对诊断宫颈癌与癌前病变的阳性预测值0.45,阴性预测值0.94;HR-HPV检测宫颈上皮病变的阳性预测值为0.52,阴性预测值为0.93。TCT联合HR-HPV检测宫颈上皮病变的阳性预测值为0.69(34/49),高于TCT的阳性预测值,差异有统计学意义(χ2=7.290,P=0.007),与HR-HPV阳性预测值差异无统计学意义(χ2=3.386,P=0.066)。结论 TCT与HR-HPV检测是宫颈上皮病变筛查的理想方法,两种方法联合应用可提高宫颈上皮病变的阳性预测值。
Abstract：Objective To analyze the difference the value of the ThinPrep cytology test(TCT) and high risk human papillomavirus(HR-HPV) testing in screening cervical epithelial lesions.Methods Specimens form 3723 women in Chaozhou city guangdong privence were tested by TCT and HR-HPV testing.The samples with TCT or HR HPV positive were examinated by histopathology of the cervical tissue.Furthermore,the effectiveness of TCT or HR-HPV testing and combining both were evaluated in cervical cancer screening.Results 78 cases were positive in TCT,ASC 15(19.2%) ;LSIL 44(56.4%) ;HSIL 19(20.2%).65 cases were positive in HR-HPV testing.Positive rate of HR HPV was 1.7%(65 /3723).Among 94 cases with histopathological diagnosis,19(20.2%) were inflammation,39(41.5%) CINⅠ,15(16.0%) CINⅡ,20(8.16%) CINⅢ,1(1.1%) SCC.The positive predictive value and negative predictive value were 0.45 and 0.94 respectly of TCT in cervical epithelial lesions screening,that were 0.52 and 0.93 in HR-HPV testing.The positive predictive value was 0.69 of TCT combined HR-HPV testing,which showed higher than TCT,and it was significant difference(χ2 = 7.290,P = 0.007),but was no difference with HR-HPV testing in screening of cervical epithelial lesions(χ2 = 3.386,P = 0.066).Conclusions TCT and HR-HPV testing are effective method in screening of cervical epithelial lesions.TCT combined HPV testing increase the positive predictive value in screening of cervical epithelial lesions.
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基本信息:
DOI：10.19757/j.cnki.issn1674-7763.2011.03.006
中图分类号:R737.33
引用信息:
[1]郜红艺,李兵,毛玲芝,等.薄层液基细胞学与高危型人乳头瘤病毒检测在宫颈上皮病变筛查中应用价值[J].中国妇幼卫生杂志,2011,2(03):124-127.DOI:10.19757/j.cnki.issn1674-7763.2011.03.006.