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目的评价宫颈液基细胞学(TCT)和HPV及两者联合检查在宫颈癌筛查中的临床价值。方法选择在妇科门诊就诊、有性生活史并行TCT检查的患者6557例,其中TCT检查结果为意义不明确的非典型鳞状细胞(ASCUS)及以上、肉眼观察可疑宫颈病变的350例患者行HPV分型检查,136例患者同时行病理学检查。结果 TCT异常(≥ASCUS)率为4.06%,HPV感染率为21.71%,TCT结果各个级别与HPV感染率比较差异有统计学意义(P<0.01);单独TCT筛查宫颈病变的灵敏度为84.85%,特异度为35.71%,诊断符合率为59.56%;单独HPV筛查宫颈病变的灵敏度为62.12%,特异度为81.43%,诊断符合率为72.06%;两者联合筛查时,其灵敏度为98.48%,特异度为84.29%,诊断符合率为89.13%。结论 TCT和HPV联合筛查较单一筛查具有更好的优势,而作为单一项目筛查时,HPV检测的临床价值更高于TCT检查。
Objective To evaluate the clinical value of cervical liquid-based cytology (TCT) and HPV and their combination in cervical cancer screening. Methods A total of 6557 patients with gynecological outpatient visits who had a history of sexual intercourse and who underwent TCT were selected. Among them, TCT was found in atypical undifferentiated squamous cells (ASCUS) Type examination, 136 patients simultaneously pathological examination. Results TCT abnormality (≥ASCUS) rate was 4.06%, HPV infection rate was 21.71%, TCT results of various levels and HPV infection rates were significantly different (P <0.01); TCT alone screening for cervical lesions sensitivity was 84.85% , The specificity was 35.71%, the diagnostic coincidence rate was 59.56%. The sensitivity of HPV screening for cervical lesions was 62.12%, the specificity was 81.43%, the diagnostic coincidence rate was 72.06%. The sensitivity of combined screening was 98.48 %, The specificity was 84.29%, the diagnostic coincidence rate was 89.13%. Conclusion The combined screening of TCT and HPV has better advantages than single screening, and as a single item screening, the clinical value of HPV testing is higher than that of TCT.