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目的:探究液基薄层细胞学检测(TCT)与高危人乳头瘤病毒(HR-HPV)筛查联合检查在宫颈癌(CC)筛查中的临床价值。方法:选择2013年4月~2015年4月期间我院就诊疑似CC患者318例为研究对象;研究对象均进行HR-HPV筛查、TCT检查及阴道镜下病理活检,评价三种筛查结果的临床应用价值。结果:318例可疑CC患者中,病理学诊断炎症患者162例(50.94%),宫颈上皮内瘤样变(CIN)患者151例(47.48%),鳞癌(SCC)患者5例(1.57%);HR-HPV、TCT及HPV+TCT联合对诊断结果与病理诊断的符合率分别为78.30%、85.22%和99.37%;HR-HPV与TCT单独检测的符合率随患者病情进展呈现升高趋势(P<0.05);TCT、HR-HPV检测单独进行诊断的敏感度、特异度均低于联合诊断(P<0.05);HR-HPV与TCT联合检测诊断CC的敏感度为98.71%、特异度100%。结论:TCT检查HR-HPV筛查联合检查CC的敏感性、特异性及准确性高,为CC筛查的有效方式,值得在临床应用推广。
Objective: To investigate the clinical value of combined examination of liquid-based TLCT and high-risk human papillomavirus (HR-HPV) screening in cervical cancer (CC) screening. Methods: A total of 318 patients with suspected CC in our hospital from April 2013 to April 2015 were enrolled in this study. All subjects were screened by HR-HPV, TCT and biopsy under colposcopy to evaluate the results of three screening tests The clinical value. Results: Of the 318 suspected CC patients, 162 cases (50.94%) were pathologically diagnosed with inflammation, 151 (47.48%) with cervical intraepithelial neoplasia (CIN) and 5 (1.57%) with squamous cell carcinoma (SCC) The coincidence rates of HR-HPV, TCT and HPV + TCT were 78.30%, 85.22% and 99.37% respectively. The coincidence rate of HR-HPV and TCT alone showed an increasing trend with the progression of the disease P <0.05). The sensitivity and specificity of TCT and HR-HPV test alone were lower than those of combined diagnosis (P <0.05). The sensitivity and specificity of combined detection of HR-HPV and TCT were 98.71% and 100 %. Conclusion: The sensitivity, specificity and accuracy of TCT examination HR-HPV screening combined with CC are high, which is an effective way of CC screening. It is worth to be popularized in clinical application.