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目的:评价检测尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌的临床意义。方法:对1030例宫颈癌前病变、早期宫颈癌、中晚期宫颈癌、非宫颈部位的7种癌以及宫颈正常或宫颈良性炎症妇女,采用子宫颈癌快速自检试剂盒(fast self test-SH for screening cervical cancer,FST-SH)检测其尿中巯基。结果:特异度为94.86%;阳性率、准确度、阳性预测值、阴性预测值、约登指数、阳性似然比,在宫颈癌前病变组为35.71%、87.42%、50.00%、91.11%、0.31、6.95;在早期宫颈癌组为65.87%、87.77%、80.58%、89.78%、0.61、12.82;在中晚期宫颈癌组为80.54%、90.24%、88.17%、91.11%、0.75、15.67;在非宫颈部位的7种癌组为12.41%、60.78%、62.96%、60.59%、0.07、2.41。结论:采用子宫颈癌快速自检试剂盒测定尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌患者,阳性率显著高于非宫颈部位的7种癌(P<0.01),且灵敏度随着病情加重而升高(r=0.99,P<0.05)。根据阳性结果判断为宫颈癌前病变或宫颈癌患者具有较高的准确度和阳性预测值及阳性似然比。根据阴性结果区分为非宫颈癌前病变或宫颈癌患者时具有很高的特异性和阴性预测值。因此,该方法适用于筛诊宫颈癌前病变和宫颈癌,但不适用于筛诊非宫颈部位的7种癌。
Objective: To evaluate the clinical significance of detection of urinary sulfhydryl screening cervical precancerous lesions, early cervical cancer, advanced cervical cancer. Methods: A total of 1030 women with cervical precancerous lesions, early cervical cancer, advanced cervical cancer, non-cervical cancer and normal or benign cervix cervix inflammation were recruited by fast self test-SH for screening cervical cancer, FST-SH). Results: The specificity was 94.86%. The positive rate, accuracy, positive predictive value, negative predictive value, Youden index, positive likelihood ratio were 35.71%, 87.42%, 50.00%, 91.11% in cervical precancerous lesions, 0.31, and 6.95 in the early stage of cervical cancer group, and were 65.87%, 87.77%, 80.58%, 89.78%, 0.61 and 12.82 in the early stage of cervical cancer group, 80.54%, 90.24%, 88.17%, 91.11%, 0.75 and 15.67 in the advanced cervical cancer group. The non-cervical cancer of the 7 groups were 12.41%, 60.78%, 62.96%, 60.59%, 0.07, 2.41. Conclusion: The positive rates of urinary sulfhydryl screening for cervical precancerous lesions, early cervical cancer and advanced cervical cancer were significantly higher than those of non-cervical cancer (P <0.01) The sensitivity increased with the aggravation (r = 0.99, P <0.05). According to the positive results of cervical precancerous lesions or cervical cancer patients with high accuracy and positive predictive value and positive likelihood ratio. According to the negative result is divided into non-cervical precancerous lesions or cervical cancer patients with high specificity and negative predictive value. Therefore, this method is suitable for screening precancerous cervical lesions and cervical cancer, but not suitable for screening non-cervical cancer of the 7 types.