摘要
目的:探讨阴道镜联合HPV-DNA检测在宫颈上皮内瘤变(CIN)及人乳头瘤病毒(HPV)亚临床感染(SPI)诊断中的应用价值及临床意义。方法:将572例宫颈细胞学阳性患者随机分为两组,观察组351例均进行高危型HPV-DNA检测及阴道镜图像定位取活检,对照组221例仅做传统肉眼宫颈四点活检,对高级别的CIN及宫颈癌患者以手术后标本病检结果为最后诊断标准,对两种诊断结果进行比较分析。结果:观察组宫颈活检病理诊断阳性率52.14%,HPV阳性率41.31%,手术标本病检结果诊断符合率为100.00%,宫颈活检漏诊率为0%。对照组宫颈活检诊断阳性率为34.39%,HPV阳性率12.67%,手术标本病检结果诊断符合率为71.43%,宫颈活检漏诊率9.95%。二者在宫颈活检阳性率、HPV阳性率、诊断符合率、宫颈活检漏诊率比较差异均有统计学意义(P<0.05),在SPI中二者阳性率差异有统计学意义(P<0.05)。结论:阴道镜联合HPV-DNA检测在宫颈癌前病变,特别是在高级别宫颈上皮内瘤变及人乳头瘤病毒亚临床感染诊断中阳性预测值较理想、敏感性较好、漏诊率低,具有较高的推广价值。
Objective：To investigate the diagnosis value and clinical significance of combined colposcopy HPV-DNA test in cervical intraepithelial neoplasia（CIN） and human papillomavirus（HPV） subclinical infection（SPI）. Methods：572 cases of cervical cytology-positive patients were randomly divided into two groups,35 cases（experimental group） proceeded HPV-DNA testing of high-risk type and colposcopy image localization biopsy,221 cases（control group） only treated with traditional four-point visual cervical biopsy.For patients with high level of CIN and cervical cancer,the final diagnostic criteria depended on the surgical pathology specimens.Then,the results of two diagnostic methods were analyzed. Results：In the experimental group,the positive rate of cervical biopsy diagnosis was 52.14%,HPV-positive rate was 41.31%,and cervical biopsy missed diagnosis rate was 0.Coincident rate of diagnostic results and pathology results was 100%.While in the control group,the positive rate of cervical biopsy diagnosis was 34.39%,HPV-positive rate was 12.67%,with 71.43% coincident rate.It was mainly caused by the wrong grade cervical lesions and high cervical biopsy misdiagnosis rate 9.95%.Compared the positive rate in cervical biopsies,HPV-positive rate,diagnostic rate and misdiagnosis rate of cervical biopsy of experimental groups with control group,the difference were significant（P0.05）.In the SPI comparison,the difference of positive rate between two group was significant too（P0.05）. Conclusion：HPV-DNA testing combined colposcopy show a good positive predictive value,better sensitivity,and low misdiagnosis rate with high promotional value in cervical precancerous lesions,especially in low-grade cervical intraepithelial neoplasia（CIN） and human papillomavirus（HPV） subclinical infection（SPI） diagnosis.
出处
《中国妇幼保健》
CAS
北大核心
2011年第8期1252-1255,共4页
Maternal and Child Health Care of China
