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TCT联合HPV及CA125在体检人群早期宫颈癌筛查中的价值

Value of TCT combined with HPV and CA125 in early cervical cancer screening in a medical examination population.

作者信息

Xiao Meiping, Zhang Zhiying, Yu Xiaohong, Fan Yinbai, Chen Xuehong

机构信息

Department of physical examination, Ganzhou people's Hospital of Jiangxi Province, Ganzhou, Jiangxi431000, China.

Department of imaging, Ganzhou people's Hospital of Jiangxi Province, Ganzhou, Jiangxi431000, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2022 Sep 30;68(9):160-164. doi: 10.14715/cmb/2022.68.9.25.

Abstract

This research aimed to explore the clinical value of thin prep cytologic test (TCT) combined with human papillomavirus (HPV) and carbohydrate antigen 125 (CA125) in early cervical cancer screening in the physical examination population. For this purpose, a total of 3587 females who received gynecological physical examination in the outpatient department of Ganzhou people's Hospital from January 2018 to March 2022 were included and underwent TCT, HPV and carbohydrate antigen 125 upon admission. Colposcopy biopsy was performed on patients who tested positive for any of the three indicators. Then using pathological diagnosis as the gold standard, the three methods applied alone or in combination were evaluated in terms of sensitivity, specificity, diagnostic yield and Youden index. Results showed that Among the 3587 females, 476 (13.27%) were HPV positive, 364 (10.14%) CA125 positive, and 314 (8.75%) TCT positive. Furthermore, 738 tested positive for any of the three indicators and underwent cervical biopsy. Among the 738 cases, 280 (39.94%) developed chronic cervicitis, 268 (36.31%) low-level cervical intraepithelial neoplasia (CIN), 173 (23.44%) high-level CIN, and 17 (2.30%) cervical cancer. HPV+TCT+CA125 combined screening showed higher sensitivity (94.54%), specificity (83.92%), diagnostic coincidence rate (87.46%) and Youden index (0.760) than single-indicator examinations. Also, it had the largest area under the receiver operating characteristic (ROC) curve, 0.673 (0.647, 0.699), compared to any other screening method. In conclusion, The combined detection of CA125, HPV and TCT is of clinical significance due to its higher sensitivity and accuracy in early screening of cervical cancer in the physical examination population.

摘要

本研究旨在探讨薄层液基细胞学检测(TCT)联合人乳头瘤病毒(HPV)及糖类抗原125(CA125)在体检人群早期宫颈癌筛查中的临床价值。为此,纳入了2018年1月至2022年3月在赣州市人民医院门诊部接受妇科体检的3587名女性,入院时均接受了TCT、HPV及糖类抗原125检测。对三项指标中任何一项检测呈阳性的患者进行了阴道镜活检。然后以病理诊断作为金标准,从灵敏度、特异度、诊断率及约登指数方面对单独应用或联合应用的三种方法进行了评估。结果显示,在3587名女性中,476名(13.27%)HPV呈阳性,364名(10.14%)CA125呈阳性,314名(8.75%)TCT呈阳性。此外,738名三项指标中任何一项检测呈阳性并接受了宫颈活检。在这738例病例中,280例(39.94%)为慢性宫颈炎,268例(36.31%)为低级别宫颈上皮内瘤变(CIN),173例(23.44%)为高级别CIN,17例(2.30%)为宫颈癌。HPV+TCT+CA125联合筛查的灵敏度(94.54%)、特异度(83.92%)、诊断符合率(87.46%)和约登指数(0.760)均高于单项指标检测。与任何其他筛查方法相比,其受试者工作特征(ROC)曲线下面积最大,为0.673(0.647,0.699)。总之,CA125、HPV和TCT联合检测在体检人群早期宫颈癌筛查中具有较高的灵敏度和准确性,具有临床意义。

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