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目的探讨血清微量元素水平预测新疆巴楚县维吾尔族妇女HPV感染、宫颈高级别病变及宫颈癌的价值,为微量元素在预防控制和治疗宫颈疾病方面提供依据。方法 2014年3月1日-6月15日在新疆巴楚县选择细胞学ASC-US及以上、care HPV检测阳性或VIA/VILI阳性者646例及2011年3月1日-2014年6月15日在新疆医科大学附属肿瘤医院妇科住院确诊的来自巴楚县的宫颈疾病患者187例进入研究队列。检出宫颈高级别病变(≥CIN2)及宫颈癌者作为病例组,慢性宫颈炎及CINⅠ级者作为对照组;HPV感染者作为阳性组,未感染者作为阴性组。采用原子荧光光谱法、电子耦合-等离子体原子发射光谱仪测定血清中铁(Fe)、砷(As)、镍(Ni)、硒(Se)微量元素含量,采用诊断试验评价与接收者工作特征曲线来分析血清微量元素对HPV感染、宫颈高级别病变及宫颈癌的预测价值。结果 As、Ni、Se预测HPV感染的诊断价值均较低,ROC曲线下面积<0.7;单用Se、Se和As联合、Se和Ni联合用于预测宫颈高级别病变及宫颈癌的诊断价值中等,ROC曲线下面积>0.7,其灵敏度和阴性预测价值较高,假阴性率较低,但特异度、正确率和阳性预测价值较低,假阳性率较高。结论血清Se、Se和As联合、Se和Ni联合可用于新疆巴楚县维吾尔族妇女宫颈高级别病变及宫颈癌的初步筛检。
Objective To investigate the value of serum trace elements in predicting the level of HPV infection, high grade cervical lesions and cervical cancer in Uygur women in Bachu County, Xinjiang, and to provide evidences for the prevention and control of cervical diseases. Methods From March 1 to June 15, 2014, 646 cases of cytology ASC-US and above were selected in Bachu county, Xinjiang province, 646 cases were positive for care HPV test or VIA / VILI positive test, and from March 1, 2011 to June 2014 On the 15th, 187 cases of cervical diseases from Bachu County, confirmed by gynecological hospitalization of the Affiliated Tumor Hospital of Xinjiang Medical University, were included in the study cohort. High grade cervical lesions (≥CIN2) and cervical cancer were detected as case group, chronic cervicitis and CIN Ⅰ grade as control group; HPV-infected patients as positive group and uninfected as negative group. The contents of trace elements (Fe, As, Ni, Se) in serum were determined by atomic fluorescence spectrometry and electron coupling-plasma atomic emission spectrometry. The diagnostic test evaluation and receiver operating characteristic curve To analyze the predictive value of serum trace elements for HPV infection, high grade cervical lesions and cervical cancer. Results The diagnostic value of As, Ni and Se in predicting HPV infection was low, and the area under the ROC curve was less than 0.7. Se, Se, and As combined with Se, Ni combined for the diagnosis of high grade cervical lesions and cervical cancer were moderate diagnostic value The area under the ROC curve was> 0.7. The sensitivity and negative predictive value were higher, the false negative rate was lower, but the specificity, correctness and positive predictive value were lower, and the false positive rate was higher. Conclusion Serum Se, Se and As combined with Se and Ni can be used in primary screening of cervical lesions and Uterine cervix in Uighur women in Bachu County, Xinjiang Uygur Autonomous Region.