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目的:探讨液基细胞学检测技术(LCT)结合高危型人乳头状瘤病毒(HPV)检测诊断宫颈癌前病变的效果。方法:采用LCT以及高危型HPV检测技术对受检者进行宫颈癌的筛查,对上述检测为阳性者、均为阴性者依意愿进行阴道镜下宫颈活组织检查。结果:LCT检测为阳性122例,高危型HPV阳性72例,两者均为阳性32例,LCT和高危型HPV均为阴性5468例;其中经LCT检测为阳性者和高危型HPV阳性者进行病理活组织检查结果为阳性的分别为92例和56例。LCT和高危型HPV检测均为阴性的5 468例中,有2 000例自愿进行病理检查,其中1例病理检查结果为阳性。LCT检测诊断宫颈癌前病变的灵敏度为73.60%,特异度为98.53%;高危型HPV检测诊断宫颈癌前病变的灵敏度为44.80%,特异度为99.21%;两种方法结合诊断(其中1项阳性即判定为患者)宫颈癌前病变的灵敏度为99.20%,特异度为99.70%,阳性似然比为330.67,阴性似然比为0.01,阳性似然比明显高于前两种方法单用的值,而阴性似然比则明显较低(P<0.01)。结论:液基细胞检测技术结合高危型HPV检测优于单项方法检测,对于宫颈癌前病变的筛检具有重要意义。
Objective: To investigate the effect of liquid-based cytology (LCT) combined with high-risk human papillomavirus (HPV) in the diagnosis of cervical precancerous lesions. Methods: Cervical cancer was screened by LCT and high-risk HPV test. Cervical cancer was screened by colposcopy according to the willingness of the above tests. Results: LCT was positive in 122 cases, high-risk HPV was positive in 72 cases, both were positive in 32 cases, LCT and high-risk HPV were negative in 5468 cases; LCT positive and high-risk HPV positive pathological Biopsy results were positive for 92 and 56 cases, respectively. LCT and high-risk HPV tests were negative 5 468 cases, 2 000 cases of voluntary pathological examination, including 1 case of pathological examination was positive. The sensitivity and specificity of LCT in diagnosis of cervical precancerous lesions were 73.60% and 98.53% respectively. The sensitivity and specificity of high-risk HPV testing in diagnosis of cervical precancerous lesions were 44.80% and 99.21% respectively. Two methods combined with diagnosis (one positive That is, the patient was judged as) cervical precancerous lesions with sensitivity of 99.20%, specificity of 99.70%, positive likelihood ratio of 330.67, negative likelihood ratio of 0.01, the positive likelihood ratio was significantly higher than the former two methods alone , While the negative likelihood ratio was significantly lower (P <0.01). Conclusion: Liquid-based cytometry combined with high-risk HPV test is superior to single test, which is of great significance for the screening of cervical precancerous lesions.