【摘要】 目的探讨人类乳头瘤病毒(human papillomavirus)HPV分型与液基细胞学(thinprep cytology test,TCT)联合检测与单纯HPV分型检测在宫颈癌及癌前病变筛查中的效能差异。方法对2017年4月至2018年2月进行宫颈癌及癌前病变筛查的375例患者进行HPV分型和TCT检测,以病理学诊断为"金标准",比较两种检测方法单独以及联合对宫颈癌及癌前病变筛查的诊断效能。结果共检出低危HPV患者138例,高危HPV患者237例。HPV分型、TCT以及两者联合检测与病理结果的诊断符合率分别为84.00%、79.47%和82.40%。HPV分型检测的灵敏度和阴性预测值高于TCT(χ2=34.281、21.908,P=0.000、0.000),特异度和阳性预测值差异无统计学意义(χ2=3.812、0.439,P=0.051、0.508)。两种方法联合检测的诊断符合率、敏感度、特异度、阳性预测值、阴性预测值与HPV分型单独检测差异均无统计学意义(P均>0.05)。结论与TCT比较,HPV分型检测更灵敏,漏诊少;应用两种方法联合检测的诊断效能与HPV分型检测无差异。更多还原

【Abstract】 Objective To explore the difference in effectiveness of human papillomavirus genotyping combined with thin-prep cytology test(TCT) screening and simple HPV typing in screening for cervical cancer and precancerous lesions. Methods The HPV genotyping and TCT data of 375 patients who were screened for cervical cancer and precancerous lesions in our hospital from April 2017 to February 2018 were analyzed retrospectively. The pathological diagnosis was "gold standard",and the diagnostic efficacy of HPV and TCT alone and combined with cervical cancer and precancerous lesions screening was compared. Results A total of138 patients with low risk HPV and 237 patients with high risk of HPV were detected. The diagnostic coincidence rate of HPV genotyping,TCT,combined detection were 84.00%,79.47% and 82.40%. The sensitivity and negative predictive value of HPV typing were significantly higher than those of TCT(χ2=34.281/21.908,P=0.000/0.000),but there was no statistical difference in the specificity and positive predictive value(χ2=3.812/0.439,P=0.051/0.508). There were no statistical difference between the combined diagnosis and HPV genotyping in the diagnostic accuracy,sensitivity,specificity,positive predictive value,negative predictive value(P all>0.05). Conclusion The sensitivity of HPV genotyping is significantly higher than that of TCT,there is no statistical difference between the combined diagnosis and HPV genotyping in the diagnostic efficiency.更多还原