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1622 例患者中,宫颈病变的 ThinPrep 细胞学检查联合 HPV 检测。

ThinPrep cytology combined with HPV detection in the diagnosis of cervical lesions in 1622 patients.

机构信息

Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.

出版信息

PLoS One. 2021 Dec 2;16(12):e0260915. doi: 10.1371/journal.pone.0260915. eCollection 2021.

Abstract

The timely detection of precancerous lesions and early intervention can greatly reduce cervical cancer occurrence. The current study aimed to assess the diagnostic value and accuracy of different methods of cervical lesion screening. A total of 1622 females who visited the Outpatient Department of Xinjiang Uyghur Autonomous Region People's Hospital between January and December 2018 were consecutively enrolled. All participants underwent separate high-risk human papilloma virus (HR-HPV) DNA detection, ThinPrep cytology testing (TCT) and colposcopic biopsy. Their medical records were retrospectively analyzed. While considering biopsy outcomes as the gold standard, the diagnostic values of TCT, HR-HPV testing, and TCT+HR-HPV testing for cervical cancer screening were compared. The sensitivity, specificity and Youden index of each method were calculated. Among the different methods, TCT+HR-HPV testing had the highest sensitivity (89.8%), followed by TCT (79.9%) and HR-HPV testing (49.2%). The combined method also had the highest Youden value, and its screening outcomes exhibited the highest consistency with those of biopsy. In addition, the combined method had the largest area under the receiver operating characteristic (ROC) curve, which was 0.673 (0.647, 0.699), compared with any other screening method. Compared with TCT or HR-HPV testing alone, TCT+HR-HPV testing serves as a better screening method for cervical cancer and precancerous lesions.

摘要

及时发现癌前病变并进行早期干预,可以大大降低宫颈癌的发生。本研究旨在评估不同宫颈病变筛查方法的诊断价值和准确性。连续纳入 2018 年 1 月至 12 月在新疆维吾尔自治区人民医院妇科门诊就诊的 1622 名女性。所有参与者均单独进行高危型人乳头瘤病毒(HR-HPV)DNA 检测、液基薄层细胞学检测(TCT)和阴道镜活检。回顾性分析其病历资料。以活检结果为金标准,比较 TCT、HR-HPV 检测和 TCT+HR-HPV 检测在宫颈癌筛查中的诊断价值。计算各方法的敏感度、特异度和约登指数。不同方法中,TCT+HR-HPV 检测的敏感度最高(89.8%),其次是 TCT(79.9%)和 HR-HPV 检测(49.2%)。联合方法的约登指数最高,与活检结果的一致性最高。此外,联合方法的受试者工作特征曲线(ROC)下面积最大,为 0.673(0.647,0.699),明显大于其他任何筛查方法。与 TCT 或 HR-HPV 检测单独应用相比,TCT+HR-HPV 检测是一种更好的宫颈癌及癌前病变筛查方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2993/8638999/1f0dad590722/pone.0260915.g001.jpg

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