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目的探讨液基薄层细胞学检查(TCT)与高危型人乳头状瘤病毒(HPV)-DNA检测在宫颈癌筛查中的应用价值。方法选取696例在盐城市妇幼保健院进行宫颈癌筛查的妇女作为研究对象,均进行宫颈TCT和HPV-DNA检测,并在阴道镜下取宫颈活体组织进行病理学诊断,分析TCT和HPV-DNA检测对宫颈癌的诊断结果。结果 TCT诊断宫颈癌的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为76.15%、75.15%、77.05%、74.70%、77.47%;HPV-DNA检测诊断宫颈癌的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为85.78%、90.00%、81.97%、81.82%、90.09%。与TCT相比,HPV-DNA检测诊断宫颈癌的敏感性、阴性预测值明显更高(P<0.05)。HPV-DNA+TCT诊断宫颈癌的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为89.80%、97.27%、83.06%、83.81%、97.12%。与单纯HPV-DNA和单纯TCT相比,HPV-DNA+TCT诊断宫颈癌的敏感性明显更高(P<0.05),同时准确性、特异性、阳性预测值、阴性预测值也有所提高。结论 TCT和HPV-DNA检测都是宫颈癌筛查的有效手段,二者联用能够有效提高诊断宫颈癌的敏感性,降低漏诊率,具有重要的临床应用价值。
Objective To investigate the value of TCT and high-risk human papillomavirus (HPV) -DNA in the screening of cervical cancer. Methods A total of 696 women who were screened for cervical cancer in Yancheng Maternal and Child Health Hospital were enrolled in this study. Cervical TCT and HPV-DNA were detected. Cervical cervical tissues were examined under colposcopy for pathological diagnosis. TCT and HPV- DNA test for diagnosis of cervical cancer. Results The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TCT in diagnosis of cervical cancer were 76.15%, 75.15%, 77.05%, 74.70% and 77.47%, respectively. The accuracy of HPV- Sensitivity, specificity, positive predictive value and negative predictive value were 85.78%, 90.00%, 81.97%, 81.82%, 90.09% respectively. Compared with TCT, HPV-DNA test for the diagnosis of cervical cancer sensitivity, negative predictive value was significantly higher (P <0.05). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of HPV-DNA + TCT in diagnosing cervical cancer were 89.80%, 97.27%, 83.06%, 83.81% and 97.12%, respectively. Compared with pure HPV-DNA and pure TCT, the sensitivity of HPV-DNA + TCT in diagnosing cervical cancer was significantly higher (P <0.05), and the accuracy, specificity, positive predictive value and negative predictive value were also improved. Conclusion Both TCT and HPV-DNA detection are effective methods for cervical cancer screening. The combination of TCT and HPV-DNA can effectively improve the sensitivity of cervical cancer diagnosis and reduce the rate of misdiagnosis, which has important clinical value.