摘要目的 探究薄层液基细胞学检测(TCT)与人乳头瘤病毒(HPV)检测联合阴道镜检查对宫颈癌前期病变患者早期诊断效能的影响.方法 选取2015年1月至2017年12月忻州市人民医院收治的初次接受宫颈癌筛查的妇女624例,均接受TCT、HPV及阴道镜检查,统计并对比TCT、HPV、阴道镜检查对宫颈癌前期病变早期诊断的准确度、敏感度及特异度.结果 624例初次接受宫颈癌筛查妇女,经组织病理学检查结果证实108例患者存在上皮细胞病变,其中意义未明确的非典型鳞状细胞(ASCUS) 38例,低度鳞状上皮病变(LSIL) 41例,高度鳞状上皮病变(HSIL) 29例.联合诊断的敏感度(91.66％)、符合率(92.46％)高于TCT(68.51％、88.46％)、HPV(69.44％、88.72％)、阴道镜检查(66.66％、88.30％)单项诊断,且Kappa指数大于单项诊断(P＜0.05);联合诊断的特异度(92.63％)与TCT(92.63％)、HPV(92.82％)、阴道镜检查(92.82％)单项诊断比较,差异未见统计学意义(P＞0.05).结论 TCT与HPV检测联合阴道镜检查有助于提高宫颈癌前期病变患者早期诊断的准确度、敏感度,对评估宫颈癌在人群中发病趋势、控制病情进展、防止宫颈癌发生、积极处理宫颈癌前期病变具有积极临床意义.

abstractsObjective To investigate the influence of thin-cytologic test (TCT) and human papillomavirus (HPV) detection combined with colposcopy on the early diagnosis of precancerous cervical cancer.Methods A total of 624 women who were initially screened for cervical cancer in Xinzhou People's Hospital from January 2015 to December 2017 were selected.All of them received TCT,HPV and colposcopy detection.The accuracy,sensitivity and specificity of TCT and HPV detection and colposcopy in early diagnosis of cervical precancerous lesions were compared.Results A total of 624 women were initially screened for cervical cancer,and 108 cases of epithelial lesions were confirmed by histopathological examination.Among them,38 cases were atypical squamous cell of undetermined significance (ASCUS),41 cases were low grade squamous intraepithelial leison (LSIL) and 29 cases were high grade squamous intraepithelial leison (HSIL).The sensitivity and coincidence rate of combined diagnosis method (91.66％,92.46％) were higher than those single diagnoses,including TCT (68.51％,88.46％),HPV (69.44％,88.72％) and colposcopy (66.66％,88.30％).And Kappa index was greater than single diagnoses (P ＜ 0.05).The specificity of combined diagnosis method (92.63％) was not significantly different from that of TCT (92.63％),HPV (92.82％) and colposcopy (92.82％) single diagnosis method (P ＞ 0.05).Conclusions TCT and HPV combined with colposcopy can improve the accuracy and sensitivity of early diagnosis of precancerous lesions of cervical cancer,which is of positive clinical significance in assessing the morbidity trend of cervical cancer in the population,control of disease progression,prevention against cervical cancer and the active treatment of precancerous lesions of cervical cancer.