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叶酸受体介导染色液检测在宫颈癌筛查中的临床应用

Clinical Application of Folate Receptor-Mediated Staining Solution Detection in Cervical Cancer Screening.

作者信息

Qi Weihong, Lv Qiubo, Ma Lijie, Tian Wenying

机构信息

Obstetrics and Gynecology Department, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, China.

Obstetrics and Gynecology Department, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, China

出版信息

Ann Clin Lab Sci. 2020 Jan;50(1):73-78.

Abstract

OBJECTIVE

Cervical cancer is the fourth most deadly women's cancer worldwide, and regular screening is essential to lower mortality rates. The folate receptor-mediated staining solution detection (FRD) has been suggested to be a rapid and cost-effective screening method. We aim to evaluate the validity of FRD testing in cervical cancer screening.

METHODS

A total of 207 participants were enrolled in the study. The validity of screening by FRD, cytology screening, and a HPV test were compared using histopathology as the gold standard. Sensitivity, specificity, positive predictive value, negative predictive value, Kappa value, positive likelihood ratio, negative likelihood ratio, percent agreement, and positive detection rates were compared among the three screening methods.

RESULTS

83(40.1%) participants were diagnosed as NILM, 50(24.15%) were diagnosed as CIN1, and 74(35.74%) were diagnosed as CIN2+. For CIN2+, the detection rates for the FRD, cytology screening, and HPV were 75.68%, 82.09% and 93.22%, respectively. For CIN2+, the sensitivity of HPV testing (93.22%) was significantly higher than that of cytology screening (82.09%) and FRD (75.68%), while the specificity of FRD (63.91%) was higher than that of cytology screening (35.34%) and HPV test (7.56%). The percent agreement and Kappa value of FRD were significantly higher than those of the cytology screening and HPV test. In HPV-HC2+ and ASCUS patients, FRD was associated with a lower false positive rate compared to other screening methods.

CONCLUSION

Our study indicates that FRD has a good sensitivity and high specificity in cervical cancer screening, and could be a rapid, valid and cost-effective screening test.

摘要

目的

宫颈癌是全球第四大致命性女性癌症,定期筛查对于降低死亡率至关重要。叶酸受体介导的染色溶液检测(FRD)被认为是一种快速且经济高效的筛查方法。我们旨在评估FRD检测在宫颈癌筛查中的有效性。

方法

共有207名参与者纳入本研究。以组织病理学作为金标准,比较FRD筛查、细胞学筛查和HPV检测的有效性。比较三种筛查方法的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值、阳性似然比、阴性似然比、一致率和阳性检出率。

结果

83名(40.1%)参与者被诊断为未见上皮内病变或恶性病变(NILM),50名(24.15%)被诊断为宫颈上皮内瘤变1级(CIN1),74名(35.74%)被诊断为CIN2及以上病变(CIN2+)。对于CIN2+,FRD检测、细胞学筛查和HPV检测的检出率分别为75.68%、82.09%和93.22%。对于CIN2+,HPV检测的灵敏度(93.22%)显著高于细胞学筛查(82.09%)和FRD(75.68%),而FRD的特异度(63.91%)高于细胞学筛查(35.34%)和HPV检测(7.56%)。FRD的一致率和Kappa值显著高于细胞学筛查和HPV检测。在HPV-HC2+和非典型鳞状细胞不能明确意义(ASCUS)患者中,与其他筛查方法相比,FRD的假阳性率较低。

结论

我们的研究表明,FRD在宫颈癌筛查中具有良好的灵敏度和高特异度,可能是一种快速、有效且经济高效的筛查检测方法。

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