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液基薄层细胞学、高危型人乳头瘤病毒检查在宫颈癌及癌前病变筛查中的价值

陆亚玲, 张金玲, 许锬, 欧阳程欣, 张立杰. 液基薄层细胞学、高危型人乳头瘤病毒检查在宫颈癌及癌前病变筛查中的价值[J]. 中华疾病控制杂志, 2021, 25(10): 1210-1213. doi: 10.16462/j.cnki.zhjbkz.2021.10.017
引用本文: 陆亚玲, 张金玲, 许锬, 欧阳程欣, 张立杰. 液基薄层细胞学、高危型人乳头瘤病毒检查在宫颈癌及癌前病变筛查中的价值[J]. 中华疾病控制杂志, 2021, 25(10): 1210-1213. doi: 10.16462/j.cnki.zhjbkz.2021.10.017
LU Ya-ling, ZHANG Jin-ling, XU Tan, OUYANG Cheng-xin, ZHANG Li-jie. The value of liquid-based thinprep cytologic test and high-risk human papillomavirus test in the screening of cervical cancer and precancerous lesions[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1210-1213. doi: 10.16462/j.cnki.zhjbkz.2021.10.017
Citation: LU Ya-ling, ZHANG Jin-ling, XU Tan, OUYANG Cheng-xin, ZHANG Li-jie. The value of liquid-based thinprep cytologic test and high-risk human papillomavirus test in the screening of cervical cancer and precancerous lesions[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1210-1213. doi: 10.16462/j.cnki.zhjbkz.2021.10.017

液基薄层细胞学、高危型人乳头瘤病毒检查在宫颈癌及癌前病变筛查中的价值

doi: 10.16462/j.cnki.zhjbkz.2021.10.017
详细信息
    通讯作者:

    张金玲,E-mail: 398915490@qq.com

  • 中图分类号: R181.1;R711.74

The value of liquid-based thinprep cytologic test and high-risk human papillomavirus test in the screening of cervical cancer and precancerous lesions

More Information
  • 摘要:   目的  评价与比较液基薄层细胞学检查(liquid-based thinprep cytologic test, TCT)、高危型人乳头瘤病毒(high-risk human papillomavirus, HR-HPV)检查在宫颈癌及癌前病变筛查中的价值,为宫颈癌及癌前病变单项筛查方法的选择提供初步依据。  方法  收集2006年2月25日―2019年10月15日在深圳市人民医院妇科因体检进行TCT、HR-HPV和阴道镜及组织病理学检查的5 657名女性资料。细胞学阳性结果包括未明确诊断意义的不典型鳞状上皮细胞(atypical squamous cells of undetermined significance, ASC-US)及以上病变。计数资料的比较采用χ2检验,采用Logistic回归分析模型分别分析HR-HPV感染、TCT阳性与宫颈癌及癌前病变(低度宫颈上皮内瘤变及以上病变)的关系。  结果  HR-HPV阳性例数为3 857例,阳性率为68.18%。HR-HPV检查筛查宫颈癌及癌前病变的灵敏度、阳性预测值、阴性预测值均高于TCT(82.39% vs. 55.34%、51.80% vs. 47.35%、76.28% vs. 61.64%;均有P<0.001),但其特异度低于TCT(42.48% vs. 53.84%;P<0.001)。Logistic回归分析模型结果显示,HR-HPV感染女性患宫颈癌及癌前病变的风险(OR=3.42, 95% CI: 3.02~3.88, P < 0.001)高于TCT阳性女性(OR=1.48, 95% CI: 1.33~1.65, P < 0.001)。  结论  HR-HPV检查在宫颈癌及癌前病变筛查中的价值高于TCT。
  • 表  1  受检女性的基本特征[n(%)]

    Table  1.   Basic characteristics of the tested women [n(%)]

    变量 受检女性
    年龄(岁, x±s)
      21~<31 26.56±2.61
      31~<41 35.31±2.84
      41~<51 44.91±2.85
      51~<65 55.62±3.85
    HR-HPV
      阳性 3 857(68.18)
      阴性 1 800(31.82)
    TCT
      ASC-US及以上病变 2 834(50.10)
      正常 2 823(49.90)
    病理
      低度CIN及以上病变 2 425(42.87)
      正常 3 232(57.13)
    下载: 导出CSV

    表  2  TCT、HR-HPV检查筛查宫颈癌及癌前病变的评价分析[% (95% CI)]

    Table  2.   Evaluation and analysis of TCT and HR-HPV test in screening cervical cancer and precancerous lesions [% (95% CI)]

    筛查方法 灵敏度 特异度 阳性预测值 阴性预测值 一致率
    TCT 55.34(53.35~57.31) 53.84(52.11~55.55) 47.35(45.52~49.19) 61.64(59.83~63.41) 54.48(53.18~55.78)
    HR-HPV 82.39(80.82~83.86) 42.48(40.79~44.19) 51.80(50.22~53.38) 76.28(74.26~78.19) 59.59(58.31~60.86)
    P <0.001 <0.001 <0.001 <0.001 <0.001
    下载: 导出CSV

    表  3  HR-HPV感染、TCT阳性与宫颈癌及癌前病变危险性分析

    Table  3.   The analysis of HR-HPV infection, TCT positive and the risk of cervical cancer and precancerous lesions

    筛查方法 病理阳性例数 病理阴性例数 OR(95% CI)值 P
    HR-HPV 3 857 1 800 3.42(3.02~3.88) <0.001
    TCT 2 834 2 823 1.48(1.33~1.65) <0.001
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-02-02
  • 修回日期:  2021-05-03
  • 网络出版日期:  2021-11-17
  • 刊出日期:  2021-10-10

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