宫颈液基细胞学检查在宫颈癌筛查中诊断价值分析.docVIP

宫颈液基细胞学检查在宫颈癌筛查中诊断价值分析 　　【摘要】目的：分析液基细胞学检查在宫颈癌筛查中的诊断价值，探讨其临床适用性。方法：选择从2011年9月到2012年9月于我院进行保健筛查的645例已婚女性患者进行TCT检查，对细胞学检查筛查出的 ASC-US 及以上病变患者进行 HPV-DNA 检测和在阴道镜下进行病理组织学检查。观察各种检查方法的阳性比率及阴性比率，比较TCT检查方法和HPV-DNA 检测方法的灵敏度和特异度情况。结果：TCT检查中ASC-US 及以上病变 201 例，其中阴性139 例，阳性 62 例。病理组织学检查结果：TCT 阴性139例，其中组织学阴性129例，阴性率928%；组织学阳性10例，阳性率72%； TCT 阳性62例，其中组织学阴性31例，阴性率500%；组织学阳性 31例，阳性率500%。而HPV-DNA 检测阴性97 例，阳性104 例。病理组织学检查结果： HPV-DNA 阴性 97例中，组织学阴性94 例，阴性率969%，阳性3 例，阳性率31%； HPV-DNA 阳性104例，其中组织学阴性 68 例，阴性率654%，阳性 36 例，阳性率346%。两种检测方法比较结果为TCT特异度和准确度远高于HPV-DNA检测，差异有统计学意义（P005），而HPV-DNA检测敏感度高于TCT。结论：宫颈液基细胞学检查是一种简单且准确率较高的宫颈癌和前期病变筛查方法，特异性比较强，且可以降低漏诊率，对早期检查和预防宫颈病变中具有较高的诊断价值，适合临床长期推广应用。 　　【关键词】液基细胞学检查；宫颈癌；HPV-DNA 检测 　　【Abstract】Objectives： To analyze the diagnostic value of liquid-based cytology in cervical cancer screening， and to explore its clinical applicability. Methods： 645 married women that conducted health screenings in our hospital from September 2011 to September 2012 were selected. All the patients received TCT examination， and the HPV-DNA lesions detection and histopathological examination was carried out on patients whose cytology screening results was ASC-US or above. Observed the positive rate and negative rate with various inspection methods， and compared the sensitivity and specificity in the situation TCT inspection methods and HPV-DNA detection method. Results： The TCT examination results of 201 cases were ASC-US or above， including 139 negative and 62 positive cases. According to histopathological outcome： 139 cases were TCT negative， of which 129 cases were histologically negative， negative rate of 92.8% and 10 cases were histologically positive， positive rate of 7.2%； 62 cases were TCT positive， of which 31 cases were histologically negative， negative rate of 500% and 31 cases were histologically positive， positive rate of 500%. There were 97 cases and 104 cases HPV-DNA test negative and positive respectively. According to histopathological outcome： 97 cases were HPV-DNA n