2016 年第 7 期 第 14 卷

高危型人乳头瘤病毒联合液基薄层细胞学检测在宫颈早期癌变中的诊断价值及其一致性

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关键词：【关键词】宫颈早期病变高危型HPVTCT诊断价值

• 摘要：
• 【摘要】【摘要】目的 探讨高危型人乳头瘤病毒（HPV）与液基薄层细胞学技术（TCT）联合检测应用于诊断宫颈早期癌变临床价值，并分析其与病理诊断结果的一致性。方法 选取2012年4月至2013年5月在我院宫颈病理活检的患者260例，对所有入选患者均急性高危HPV联合TCT检测，以病理活检诊断结果作为金标准，对比HPV联合TCT与病理检查结果，并应用Kappa一致性检验分析其与病理诊断结果的一致性。结果 病理活检诊断作为金标准，HPV联合TCT检测的阳性预测值及特异性均明显高于单独检测方法，单独检测与联合检测方法的特异性、灵敏度及阳性预测值对比，差异均有统计学意义（P<0.05）；HPV联合TCT检测结果与病理活检结果符合率（77.86%）最高，Kappa值=0.52，一致性最高，差异有统计学意义（P<0.05）；2年随访中，病理活检诊断复发或残留10例，HPV联合TCT对残留或复发检测的特异性为93.33%、灵敏度为60.00%、阳性预测值为54.45%、阴性预测值为94.59%。结论 HPV联合TCT应用于宫颈早期癌变的诊断，检测结果与病理活检结果具有高度一致性，对宫颈病变经术后治疗残留及复发也具有较高的临床价值，值得推广应用。
• [Abstract]Objective Discussion on high-risk human papillomavirus (HPV) and TCT technology (TCT) combined detection for early diagnosis of cervical cancer clinical value, and analyze their consistency with the pathological diagnosis results.Method Choose from April 2012 to May 2013 in our hospital 260 cases of patients with cervical biopsy, and for all enrolled patients with acute joint TCT-risk HPV testing to biopsy as the gold standard for diagnosis, compared to HPV joint TCT and pathological findings and apply the Kappa consistency test to analyze the consistency and pathological diagnosis results.Result Diagnostic biopsy as the gold standard, HPV testing combined with TCT positive predictive value and specificity were significantly higher than individual detection method, the detection of specific individual and joint detection, sensitivity and positive predictive value of contrast, the differences were statistically significant (P <0.05); HPV joint TCT test results with the biopsy results consistent rate (77.86%) the highest, Kappa value = 0.52, the most consistent, the difference was statistically significant (P <0.05); 2-year follow-up biopsy diagnosis 10 cases of recurrent or residual, HPV joint TCT detection of residual or recurrent specificity of 93.33%, a sensitivity of 60.00%, 54.45% positive predictive value, negative predictive value was 94.59%.Conclusion HPV joint TCT used in the diagnosis of early stage cervical cancer, the test results with the biopsy results with a high degree of consistency of cervical lesions by postoperative treatment of residual and recurrent also has high clinical value, should be widely applied.