宫颈癌筛查系统与液基细胞学检测在宫颈病变初筛中的研究_临床医学论文.docVIP

宫颈癌筛查系统与液基细胞学检测在宫颈病变初筛中的研究_临床医学论文 宫颈癌筛查系统与液基细胞学检测在宫颈病变初筛中的研究_临床医学论文 作者：李伟宏，金松，张俊霄，吴小妹，陈华，曾蓉蓉，王丽 【摘要】 目的：探讨宫颈癌筛查系统（TruScreen）与液基细胞学检测(TCT)在宫颈病变初筛中的应用价值。方法：对1201例患者依次进行TruScreen、TCT及宫颈活检病理学检查，将其病理结果与TruScreen和TCT结果对照分析。结果：TruScreen、TCT阳性结果分别为316例和207例，病理学检查阳性结果为115例。TruScreen、TCT检测的敏感度分别为81.7%、71.3%，特异度分别为79.6%、88.5%，假阴性率分别为18.3%、28.7%，假阳性率分别为20.4%、11.5%。TruScreen检查敏感度略高于TCT，差异无统计学意义（Pgt;0.05）。结论：TruScreen的效果评价略优于TCT，具有较低的假阴性率及相对不高的假阳性率，有望成为我国宫颈病变初筛的独立方法。 【关键词】 宫颈癌筛查系统（TruScreen）；液基细胞学检测(TCT)；宫颈病变［ABSTRACT］ Objective: To study the value of cervical cancer screening system and liquid based cytology test in detection of cervical lesions. Methods: Cervical cancer screening system, liquid based cytology test and pathological test were performed in a 1201 cases, and the results of the former two were compared with pathological outcomes. Results: A total of 316, 207 and 115 cases were shown as positive according to cervical cancer screening system, liquid based cytology test and pathological test respectively indicating sensitivity of 81.7%, 71.3%; specificity of 79.6%, 88.5%; false negative rate of 18.3%, 28.7%; and false positive rate of 20.4%, 11.5% for cervical cancer screening system and liquid based cytology test. Sensitivity of cervical cancer screening system was slightly higher than that of the liquid based cytology test, while the difference was insignificant (Pgt;0.05). Conclusions: Efficacy of cervical cancer screening system is better than that of liquid based cytology test. With low false negative rate and comparatively low false positive rate, it might be used alone as primary screening method for cervical lesions in China. ［KEY WORDS］ Cancer screening system; Liquid based cytology test; Cervical lesions 据世界范围统计，每年估计有46.6万的子宫颈癌新发病例，是仅次于乳腺癌第2位女性恶性肿瘤，其中80%的病例发生在发展中国家［1］，在发展中国家居首位。近年我国宫颈癌发病率在以每年2%～3%的速度增长，并有年轻化趋势。已建立了筛查制度的发达国家的流行病学资料显示，宫颈浸润癌发病率和死亡率已经大幅度下降。宫颈癌的发生、发展是一个漫长的过程，从宫颈癌前病变(cervical intraepithelial neoplasia，CIN)发展到宫颈癌大约需10年的时间，因此，选择客观、高效的筛查方法制定筛查计划，尽可