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目的探讨液基细胞学(liquid based cytology,TCT)[1]联合高危型人乳头瘤病毒测定(high-risk human papilloma virus,HR-HPV)在宫颈癌筛查中的临床价值。方法选择体检或门诊就诊的女性就诊者986例作为研究对象,同时对就诊者进行TCT与HR-HPV检测。TCT结果≥ASCUS为阳性,HR-HPV≥1.0为阳性;对于其中任意一项或两项为阳性者,或者临床高度怀疑病变的患者进行阴道镜活检,以病理检查结果为金标准。结果单独进行TCT检测的敏感性,特异性,阳性预测值,阴性预测值分别为:91.49%,94.39%,59.72%,98.59%;单独进行HC2-HPV检测的敏感性,特异性,阳性预测值,阴性预测值分别为:89.36%,84.42%,36.05%,86.01%;TCT和HR-HPV联合检测的敏感性,特异性,阳性预测值,阴性预测值分别为:97.87%,95.73%,59.10%,98.13%;联合检测的敏感性、特异性明显优于单一方法检测。结论 TCT、HR-HPV联合检测,能最大限度地弥补其单一方法检测的缺点和不足,有效提高癌前病变和宫颈癌筛查的敏感性和准确性,减少漏诊和假阴性。
Objective To investigate the clinical value of liquid-based cytology (TCT) combined with high-risk human papilloma virus (HR-HPV) in screening cervical cancer. Methods A total of 986 female medical examinations were selected as the study subjects and TCT and HR-HPV tests were performed on the patients. TCT results ≥ASCUS positive, HR-HPV≥1.0 positive; colorectal biopsy for any one or both of them, or patients with highly suspected clinical pathology, the results of pathological examination as the gold standard. Results The sensitivity, specificity, positive predictive value and negative predictive value of TCT alone were 91.49%, 94.39%, 59.72% and 98.59% respectively. The sensitivity, specificity and positive predictive value of HC2-HPV alone , The negative predictive value were respectively 89.36%, 84.42%, 36.05% and 86.01%. The sensitivity, specificity, positive predictive value and negative predictive value of combined detection of TCT and HR-HPV were 97.87%, 95.73%, 59.10 %, 98.13%. The sensitivity and specificity of the combined detection were significantly better than the single method. Conclusions The combined detection of TCT and HR-HPV can make up for the shortcomings and deficiencies of single method detection, and improve the sensitivity and accuracy of precancerous lesions and cervical cancer screening, and reduce the missed diagnosis and false negative.