【摘要】 目的:评价现行3种子宫颈癌及癌前病变筛查方法的诊断效果。方法:对我院2009年1月～12月105位24～71岁妇女,均实施宫颈刮片细胞学和液基细胞学检查(TCT)、杂交捕获2代实验(HC2)检测高危型人乳头瘤病毒(HR-HPVDNA)、阴道镜取宫颈组织做病理检查,以病理检查结果为标准,≥中度宫颈上皮内瘤变(CIN2)为阳性,检测各筛查方法的灵敏度及特异度。结果:各筛查方法的灵敏度及特异度分别为:宫颈刮片细胞学检查(≥巴氏Ⅲ级为阳性)(0.829,0.615)、TCT(≥ASCUS/AGUS为阳性)(0.845,0.594)、HR-HPVDNA(≥1.00为阳性)(0.902,0.400)、宫颈刮片细胞学与HR-HPVDNA联合检测(二项均阳性)(0.780,0.677)、TCT与HR-HPV DNA联合检测(二项均阳性)(0.805,0.692)。宫颈刮片细胞学检查、TCT、宫颈刮片细胞学检查联合HR-HPV DNA、TCT联合HR-HPVDNA受试者工作特征(receiver operating characteristic,ROC)曲线下面积、可信区间(confidence interval)分别为0.719(0.620-0.819),0.724(0.625-0.822),0.729(0.629-0.828),0.749(0.652-0.849),各筛查方法筛查效率间差异无统计学意义。结论:宫颈刮片细胞学检查、液基细胞学检查(TCT)以及HR-HPV DNA检测是目前宫颈癌筛查有价值的方法,宫颈刮片细胞学检查与TCT检查相比筛查效率相似,分别联合HR-HPV DNA检测后筛查效率无明显增加。更多还原

【Abstract】 Objecfive:To evaluate the significance of three methords in the screening of cervical lesion.Methods:Totally 105 patients who had received screening with pap smear,thinprep cytologic test(TCT),high risk human papillomavirus(HR-HPV) and colposcopic biopsy,in department of gynecology,the first affiliated hospital school of medicine Shihezi university.HR-HPV was detected by the Hybrid Capture 2(hc2)system.Results:The results were evaluated by the colposcopic biopsy which was considered as gold standard and were compared with the index of sensitivity,specificity,for the detection of high-grade cervical intra-epithelial neoplasia(≥CIN Ⅱ),pap smear(≥grade three)(0.829,0.615),TCT(≥ASCUS/AGUS)(0.845,0.594),HR-HPV DNA(≥1)(0.902,0.400),pap smear+HR-HPV DNA(two positive)(0.780,0.677),TCT+HR-HPV(two positive)(0.805,0.692).Pap smear,TCT,pap smear+HR-HPV DNA and TCT+HR-HPV each receiver operating characteristic(ROC)and confidence interval was 0.719(0.620-0.819),0.724(0.625-0.822),0.729(0.629 -0.828),0.749(0.652-0.849).Conclusion:Pap smear,TCTand HR-HPV testing are the optimal screening approach of cervical lesion.Pap smear versus TCT have similar detection rate of screening cervical lesions,combined use of HR-HPV DNA testing will not improve the screening efficacy.更多还原