[1]见永康,吴泽俊,庄雅丽.宫颈癌筛查联合阴道镜活检防治宫颈癌前病变的价值研究[J].医学信息,2023,36(16):117-120.[doi:10.3969/j.issn.1006-1959.2023.16.022]
　JIAN Yong-kang,WU Ze-jun,ZHUANG Ya-li.Study on the Value of Cervical Cancer Screening Combined with Colposcopy Biopsy in the Prevention and Treatment of Cervical Precancerous Lesions[J].Journal of Medical Information,2023,36(16):117-120.[doi:10.3969/j.issn.1006-1959.2023.16.022]
点击复制

宫颈癌筛查联合阴道镜活检防治宫颈癌前病变的价值研究()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年16期
页码:
117-120
栏目:
论著
出版日期:
2023-08-15

文章信息/Info

Title:
Study on the Value of Cervical Cancer Screening Combined with Colposcopy Biopsy in the Prevention and Treatment of Cervical Precancerous Lesions
文章编号:
1006-1959（2023）16-0117-04
作者:
见永康; 吴泽俊; 庄雅丽
（安徽医科大学附属妇幼保健院综合妇科，安徽 合肥 230000）
Author(s):
JIAN Yong-kang; WU Ze-jun; ZHUANG Ya-li
(Department of Comprehensive Gynecology,Maternal and Child Health Hospital Affiliated to Anhui Medical University,Hefei 230000,Anhui,China)
关键词:
TCT; HPV; 阴道镜; 宫颈癌前病变; 宫颈癌
Keywords:
TCT; HPV; Colposcopy; cervical precancerous lesions; Cervical cancer
分类号:
R737.33
DOI:
10.3969/j.issn.1006-1959.2023.16.022
文献标志码:
A
摘要:
目的 探究在宫颈癌前病变防治过程中，液基细胞学检测（TCT）、人乳头状瘤病毒（HPV）DNA检测和阴道镜检查三种方法的应用价值。方法 选取安徽医科大学附属妇幼保健院2021年1月-2022年1月收治的542例疑似子宫颈癌前病变患者为研究对象，所有患者在诊断过程中均接受液基细胞学检查和HPV DNA检测并对二者中任一结果为阳性的患者行阴道镜活检，比较单独诊断与联合诊断的灵敏度、特异度、阴性预测值、阳性预测值、准确度，分析其诊断效能。结果 542例疑似宫颈病变患者中，TCT筛查阳性320例（59.04%），HPV筛查阳性487例（89.85%），TCT联合HPV检测共检出阳性患者537例（99.07%）；TCT联合HPV检测在宫颈癌前病变及宫颈癌诊断中的特异度、阳性预测值、准确度高于两者单独检测，而灵敏度低于两者单独检测，差异有统计学意义（P＜0.05）。随着宫颈活检病理级别的升高，TCT在炎症、CINⅠ、CINⅡ、CINⅢ、SCC患者的阳性率分别为43.18%、68.89%、77.28%、86.96%、100.00%，呈升高趋势；高危型HPV DNA检测的阳性率也大致与宫颈活检病理级别呈正相关，分别为86.36%、91.11%、97.72%、97.82%、87.50%，差异有统计学意义（P＜0.05）。结论 TCT、HPV DNA检测联合阴道镜检查能够提高宫颈癌筛查的特异性和准确度，有利于早期发现宫颈病变。
Abstract:
Objective To explore the effect of thinprep cytologic test (TCT), human papillomavirus (HPV) DNA test combined with colposcopy biopsy in the prevention and treatment of cervical precancerous lesions.Methods A total of 542 patients with suspected cervical precancerous lesions from January 2021 to January 2022 in the Maternal and Child Health Hospital of Anhui Medical University were selected as the research objects. All patients underwent Thinprep cytologic test and HPV DNA test during the diagnosis process, and colposcopy biopsy was performed on patients with positive results in either of the two. The sensitivity, specificity, negative predictive value, positive predictive value and accuracy of single diagnosis and combined diagnosis were compared, and their diagnostic efficacy was analyzed.Results Among the 542 patients with suspected cervical lesions, 320 patients (59.04%) were positive by TCT test, 487 patients (89.85%) were positive by HPV test, and 537 patients (99.07%) were positive by TCT combined with HPV test. The specificity, positive predictive value and accuracy of the diagnosis of cervical precancerous lesions and cervical cancer by TCT combined with HPV test were higher than those of the two separate tests, while the sensitivity was lower than that of the two separate tests, and the difference was statistically significant (P<0.05). With the increase of pathological grade of cervical biopsy, the positive rates of TCT in patients with inflammation, CINI, CINII, CINIII and SCC were 43.18%, 68.89%, 77.28%, 86.96% and 100.00%, respectively, showing an increasing trend. The positive rate of high-risk HPV DNA test was also positively correlated with the pathological grade of cervical biopsy, which was 86.36%, 91.11%, 97.72%, 97.82% and 87.50%, respectively, and the difference was statistically significant (P<0.05).Conclusion TCT, HPV DNA test combined with colposcopy can improve the specificity and accuracy of cervical cancer screening, which is conducive to the early detection of cervical lesions.

参考文献/References:

[1]Macdonald M,Crossley J,Ellis K,et al.Prevalence of high-grade cervical intraepithelial neoplasia in women with persistent high-risk HPV genotypes and negative cytology[J].Cytopathology,2018,29(2):133-142.[2]Torre LA,Bray F,Siegel RL,et al.Global cancer statistics, 2012[J].CA Cancer J Clin,2015,65(2):87-108.[3]Jill J.HPV infection and cancer[J].JAMA,2018,319(10):1058.[4]Khunamonpong S,Settakorn J,Sukpan K,et al.High performance of combined HPV testing and genotyping for HPV16/18/52/58 intriaging women with minor cervical cytological abnormalities in northem Thailand [J].Jounal of Medical Virology,2016,88(1):135-143.[5]Rader JS,Tsaih SW,Fullin D,et al.Genetic variations in human papillomavirus and cervical cancer outcomes[J].International Journal of Cancer,2019,144(9):2206-2214.[6]魏丽惠.HPV感染与HPV疫苗专题讨论-HPV感染现状及在宫颈癌和癌前病变筛查中的意义[J].实用妇产科杂志,2017,33:81-83.[7]王钧.HPV DNA分型检测及HPV E6/E7 mRNA定量检测在宫颈癌筛查中应用的研究[J].国际感染病学(电子版),2020,9(3):103.[8]Hoda RS.Non-gynecologic cytology on liquid-based preparations:A morphologic review of facts and artifacts[J].Diagn Cytopathol,2007,35(10):621-634.[9]吕倩灵,张玲,林伟平,等.高危型人乳头状瘤病毒及病毒载量对宫颈癌癌前病变的相关性分析[J].中华医院感染学杂志,2014,21(4):804-805.[10]Ugonma WD,Chiamaka LN,Chika PU,et a1.Knowledge and Attitude towards Cervical Cancer:A Case Study of Undergraduate students in Imo state,Nigeria[J].Open Access Library Journal,2020,7(6):1-11.[11]Harper DM,Nieminen P,Donders G,et al.The efficacy and safety of tipapkinogen sovacivec therapeutic HPV vaccine in cervical intraepithelial neoplasia grades 2 and 3:randomized controlled phase Ⅱ trial with 2.5 years of follow-up[J].Gynecol Oncol,2019,153(3):521-529.[12]van Gijn J,Gijselhart JP.Papanicolaou and the cervical smear[J].Ned Tijdschr Geneeskd,2012,156(40):A4965.[13]王海瑞,廖光东,江宇,等.p16/mcm2双染在宫颈上皮内瘤变的诊断价值及其与高危型HPV感染的关系[J].中华流行病学杂志,2017,38(9):1241-1245.[14]石杏先,余立群,高国兰.318例高级别宫颈上皮内瘤变及宫颈癌患者的TCT和hrHPV检测分析[J].中国肿瘤临床,2019,46(2):73-76.[15]Li H,Ruan WJ,Liu LQ,et al.Impact of taurine on the proliferation and apoptosis of human cervical carcinoma cells and its mechanism[J].Chin Med J,2019,132(8):948-956.[16]姚小艳,周芳芳,马为为.HPV基因分型联合TCT筛查宫颈病变的价值分析[J].河北医学,2021,27(2):222-227.[17]Huh WK,Ault KA,Chelmow D,et al.Use of primary high-risk human papillomavirus testing for cervical cancer screening:interim clinical guidance[J].Gynecol Oncol,2015,136(2):178-182.[18]Cremer ML,Maza M,Alfaro KM,et al.Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador[J].J Low Genit Tract Dis,2016,20(2):145-150.[19]李琪.液基细胞学、阴道镜组织活检和HPV-DNA检测防治宫颈癌前病变的价值研究[J].中国妇幼保健,2018,33(15):3578-3580.[20]Talia KL,Stewart CJR,Howitt BE,et al.HPV-negative gastric type adenocarcinoma in situ of the cervix: A spectrum of rare lesions exhibiting gastric and intestinal differentiation[J].Pathology,2018(50):8.

相似文献/References:

[1]聂小凤,翟慧慧,冷天艳,等.宫颈脱落细胞miR34a检测在HR-HPV阳性患者 分流中的作用分析[J].医学信息,2018,31(16):43.[doi:10.3969/j.issn.1006-1959.2018.16.012]
　NIE Xiao-feng,ZHAI Hui-hui,LENG Tian-yan,et al.Analysis of the Role of MiR34a in Cervical Exfoliated Cells in Shunt of HR-HPV Positive Patients[J].Journal of Medical Information,2018,31(16):43.[doi:10.3969/j.issn.1006-1959.2018.16.012]
[2]邬素珍,许焕英.宫颈人乳头瘤病毒感染的免疫研究进展[J].医学信息,2018,31(19):33.[doi:10.3969/j.issn.1006-1959.2018.19.012]
　WU Su-zhen,XU Huan-ying.Progress in Immunization of Cervical Human Papillomavirus Infection[J].Journal of Medical Information,2018,31(16):33.[doi:10.3969/j.issn.1006-1959.2018.19.012]
[3]刘琳琳,宫 正,杨海嵘,等.宫颈癌的诊治及预防研究[J].医学信息,2021,34(03):49.[doi:10.3969/j.issn.1006-1959.2021.03.015]
　LIU Lin-lin,GONG Zheng,YANG Hai-rong,et al.Research on Diagnosis,Treatment and Prevention of Cervical Cancer[J].Journal of Medical Information,2021,34(16):49.[doi:10.3969/j.issn.1006-1959.2021.03.015]
[4]祝亚军.高危型HPV-DNA及TCT检测筛查宫颈癌及宫颈癌前病变的价值[J].医学信息,2019,32(22):157.[doi:10.3969/j.issn.1006-1959.2019.22.054]
　ZHU Ya-jun.The Value of Screening High-Risk HPV-DNA and TCT for Cervical Carcinoma and Cervical Precancerous Lesions[J].Journal of Medical Information,2019,32(16):157.[doi:10.3969/j.issn.1006-1959.2019.22.054]
[5]刘洪波,祁晓莉,乔 星,等.HPV分型检测联合TCT检查在宫颈病变筛查中的应用[J].医学信息,2018,31(08):152.[doi:10.3969/j.issn.1006-1959.2018.08.053]
　LIU Hong-bo,QI Xiao-li,QIAO Xing,et al.Application of HPV Typing Test Combined with TCT Examination in Screening Cervical Lesions[J].Journal of Medical Information,2018,31(16):152.[doi:10.3969/j.issn.1006-1959.2018.08.053]
[6]朱 军,张振君.妇女宫颈病变筛查分析[J].医学信息,2019,32(01):139.[doi:10.3969/j.issn.1006-1959.2019.01.043]
　ZHU Jun,ZHANG Zhen-jun.Screening Analysis of Cervical Lesions in Women[J].Journal of Medical Information,2019,32(16):139.[doi:10.3969/j.issn.1006-1959.2019.01.043]
[7]邵景萍.HPV联合TCT检测在宫颈疾病筛查中的应用[J].医学信息,2022,35(10):168.[doi:10.3969/j.issn.1006-1959.2022.10.043]
　SHAO Jing-ping.Application of HPV Combined with TCT in Cervical Disease Screening[J].Journal of Medical Information,2022,35(16):168.[doi:10.3969/j.issn.1006-1959.2022.10.043]
[8]李明明,赵 芳,张亚青.TCT、HPV联合阴道镜检测在早期宫颈癌及癌前病变筛查中的应用价值[J].医学信息,2023,36(13):103.[doi:10.3969/j.issn.1006-1959.2023.13.020]
　LI Ming-ming,ZHAO Fang,ZHANG Ya-qing.Application Value of TCT, HPV Combined with Colposcopy in the Screening of Early-stage Cervical Cancer and Precancerous Lesions[J].Journal of Medical Information,2023,36(16):103.[doi:10.3969/j.issn.1006-1959.2023.13.020]
[9]王 意,李子珊,雷 雯,等.HPV E6/E7 mRNA检测对HPV16/18 DNA阳性患者的分流价值[J].医学信息,2024,37(18):57.[doi:10.3969/j.issn.1006-1959.2024.18.010]
　WANG Yi,LI Zi-shan,LEI Wen,et al.Shunt Value of HPV E6/E7 mRNA Detection in HPV16/18 DNA Positive Patients[J].Journal of Medical Information,2024,37(16):57.[doi:10.3969/j.issn.1006-1959.2024.18.010]

更新日期/Last Update: 1900-01-01