检验医学 ›› 2019, Vol. 34 ›› Issue (4): 313-317.DOI: 10.3969/j.issn.1673-8640.2019.04.005

• 临床应用研究·论著 • 上一篇    下一篇

人乳头瘤病毒DNA检测联合液基细胞学检查在宫颈病变筛查中的意义

黄燕1, 朱晓云2, 李天英2   

  1. 1.北京大学国际医院检验科,北京 102206
    2.北京大学国际医院病理科,北京 102206
  • 收稿日期:2018-08-30 出版日期:2019-04-30 发布日期:2019-05-17
  • 作者简介:null
    作者简介:黄 燕,女,1973年生,硕士,副主任技师,主要从事病原学分子诊断和生物化学标志物研究。

Role of human papillomavirus DNA assay combined with liquid-based cytology for screening cervical lesion

HUANG Yan1, ZHU Xiaoyun2, LI Tianying2   

  1. 1. Department of Clinical Laboratory,Peking University International Hospital,Beijing 102206,China
    2. Department of Pathology,Peking University International Hospital,Beijing 102206,China
  • Received:2018-08-30 Online:2019-04-30 Published:2019-05-17

摘要:

目的 探讨人乳头瘤病毒(HPV)DNA检测联合液基细胞学检查(TCT)在宫颈病变筛查中的应用价值。方法 选取2015年7月—2018年4月在北京大学国际医院妇科门诊就诊和在健康体检中心进行宫颈病变筛查者共8 498例,分别计算其高危型HPV感染和TCT的阳性率以及HPV DNA检测和TCT诊断高级别宫颈病变的敏感性和特异性。结果 高危型HPV阳性率为12.2%,TCT诊断宫颈病变的敏感性为56.0%,特异性为77.8%。HPV DNA检测诊断宫颈病变的敏感性为98.4%,特异性为48.9%。对宫颈上皮内瘤样变(CIN)≥2级的患者,TCT检查和HPV DNA检测诊断宫颈病变的敏感性分别为55.8%和99.0%。在联合筛查中,以HPV DNA初筛后联合TCT分流,诊断敏感性为90.1%,阴性预测值为91.2%。结论 以HPV DNA检测作为初筛方法,根据其结果确定是否进行TCT对宫颈病变的筛查更有价值。

关键词: 人乳头瘤病毒, 液基细胞学检查, 宫颈病变

Abstract:

Objective To investigate the role of human papillomavirus(HPV) DNA assay combined with thin prep liquid-based cytology test(TCT) in cervical lesion screening. Methods From July 2015 to April 2018,8 498 women undergoing routine cervical lesion screening were enrolled from Peking University International Hospital. HPV DNA assay and TCT were performed. The positive rate of high-risk HPV infection and the detection rate of TCT were calculated. The sensitivities and specificities of HPV DNA assay and TCT for the diagnosis of high-grade cervical lesions were evaluated. Results The positive rate of high-risk HPV infection was 12.2%. The sensitivity of TCT for the diagnosis of cervical lesions was 56.0%,and the specificity was 77.8%. The sensitivity of HPV DNA assay was 98.4%,and the specificity was 48.9%. The sensitivities of TCT and HPV DNA assay were 55.8% and 99.0% in patients with cervical intraepithelial neoplasia(CIN)≥2,respectively. Combined TCT with HPV DNA assay,the sensitivity was 90.1%,and the negative predictive value was 91.2%. Conclusions Using HPV DNA assay as primary screening method,TCT is performed or not according to the results of HPV DNA assay. This combined screening scheme is advantageous in the diagnosis of cervical lesions.

Key words: Human papillomavirus, Liquid-based cytology, Cervical lesion

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