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目的探讨HPV L1壳蛋白检测在HR-HPV阳性、TCT≤LSIL宫颈病变筛查中的分流管理价值。方法对HR-HPV阳性、TCT≤LSIL的687例妇女宫颈脱落细胞标本进行HPV L1壳蛋白检测,评价其筛查宫颈病变的灵敏度、特异度、阳性预测值、阴性预测值等。结果 HPV L1壳蛋白阳性率与宫颈病变的严重程度呈负相关(rs=-0.316)。细胞学结果NILM组中,HPV L1壳蛋白检测筛查宫颈病变(≥CIN1)的灵敏度75.4%、特异度33.9%、阳性预测值18.8%、阴性预测值87.2%;ASC-US组以上各值为71.4%、92.4%、81.8%、87.1%;LSIL组以上各值为77.0%、87.7%、89.1%、74.6%。结论 HPV L1壳蛋白对宫颈病变有预测价值,且可对HR-HPV阳性、细胞学≤ASC-US受检者进行分流管理。
Objective To investigate the value of HPV L1 capsid protein detection in HR-HPV positive, TCT ≤ LSIL screening of cervical lesions diversion management value. Methods HPV L1 capsid protein was detected in 687 cases of cervical exfoliated cells with HR-HPV positive and TCT≤LSIL. The sensitivity, specificity, positive predictive value and negative predictive value of screening cervical lesions were evaluated. Results The positive rate of HPV L1 capsid protein was negatively correlated with the severity of cervical lesions (rs = -0.316). Cytological results In the NILM group, the sensitivity and specificity of HPV L1 capsid protein in screening cervical lesions (≥CIN1) were 75.4%, 33.9%, 18.8% and 87.2%, respectively. The values of ASC-US group were 71.4%, 92.4%, 81.8% and 87.1% respectively. The above values of LSIL group were 77.0%, 87.7%, 89.1% and 74.6% respectively. Conclusion HPV L1 capsid protein has predictive value for cervical lesions, and can be used for shunt management of HR-HPV positive, cytological ≤ ASC-US subjects.