高危型HPV DNA检测与TCT在早期宫颈病变诊断中的临床价值

摘要

Objective To evaluate the clinical value of high risk HPV DNA testing and thinprep cytology test (TCT) in the diagnosis of the early cervical lesions. Method The results detected by using second-generation hydrid capture gene (HC2) HPV DNA testing and TCT in 192 cases women which admitted to Department of Gynaecology in Fuyang City People's Hospital from February 2014 to November 2015 were analyzed retrospectively. The clinical diagnostic value were compared in high risk HPV DNA testing and TCT. Result The virus loads grade of HPV DNA, the positive rates of HPV DNA, the positive rates of TCT and the positive rates of CIN and SCC were showed a linear correlation (P<0.05). The area under the curve AUC of TCT, high risk HPV DNA testing, HPV DNA testing combined with TCT was 0.795, 0.807 and 0.815. The sensitivity (98.50%), negative predictive value(95.00%), diagnostic accordance rate (88.02%) and Youden index (62.91%) of high risk HPV DNA testing combined with TCT were higher than HPV DNA testing, TCT. Conclusion As a screening tool for early cervical lesions, the combined application of high risk HPV DNA testing and TCT was the best means.%目的 探讨高危型人乳头瘤病毒(human papilloma virus,HPV)DNA检测与液基薄层细胞学技术(thinprep cytology test,TCT)在早期宫颈病变诊断中的应用价值.方法 回顾性分析2014年2月至2015年11月阜阳市人民医院妇科收治的采用第二代杂交捕获法(hybrid capture 2,HC2)进行HPV DNA检测及TCT检查的宫颈病变病例192例,比较两种方法的诊断价值.结果 高危型HPV DNA的载量分级、阳性率及TCT结果阳性率与宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及鳞状细胞癌(squamous cell carcinoma,SCC)的阳性率均呈线性相关,差异具有显著性(P<0.05).用TCT、HPV DNA检测及两者联合检查筛查宫颈CIN和SCC的ROC曲线下的面积分别为0.795、0.807、0.815,两者联合检查的灵敏度(98.50%)、阴性预测值(95.00%)、诊断符合率(88.02%)及约登指数(62.91%)均高于HPV DNA和TCT检测.结论 高危型HPV DNA检测与TCT的联合应用是宫颈早期病变筛查的最佳手段.