刘露晖 李桂宝 王栾玲 黄凤友 陈新妹 赖珍苗 贺凌云 胡红云

[摘要]目的 比较FRD和TCT检查在宫颈癌筛查中的应用价值。方法 采取自身对照法，选取2015年4月～2018年1月我院妇科门诊的2500例患者，均行FRD和TCT检查，FRD或（和）TCT结果阳性，再行阴道镜检查并取宫颈组织活检，以活检结果为金标准，评价FRD和TCT筛查的阳性检出率及FRD和TCT的诊断价值。以灵敏度、特异性、误诊率、漏诊率、阳性预测率、阴性预测率为诊断价值指标。结果 2500例患者中，FRD和TCT的阳性检出率分别为10.32% 和9.96%，两者比较差异无统计学意义（P>0.05）。FRD和TCT的灵敏度、特异性、误诊率、漏诊率、阳性预测率及阴性预测比较，差异均无统计学意义（P>0.05）。结论 FRD和TCT对宫颈癌前病变筛查均具检出效能，診断价值相当。

[关键词]宫颈癌前病变;筛查;叶酸受体介导的宫颈特殊染色;液基薄层细胞学检测

[中图分类号] R737.33          [文献标识码] A          [文章编号] 1674-4721（2019）6（c）-0031-04

[Abstract] Objective To compare the application value of folate receptor-mediated detection （FRD） and thin-prep cytology test （TCT） in cervical cancer screening. Methods By self-control method， from April 2015 to January 2018， 2500 patients in the gynaecological clinic of our hospital performed with FRD and TCT examinations were selected. When the FRD or/and TCT outcomes were positive， the cervical biopsy under colposcope was performed. The biopsy result was set as the golden standard. The positive detection rate of FRD and TCT screening and the diagnostic values of FRD and TCT were evaluated， the parameters were sensitivity， specificity， misdiagnosis rate， missed diagnosis rate， positive predictive rate， and negative predictive rate. Results Among 2500 patients， the positive detection rates of FRD and TCT were 10.32% and 9.96%， respectively， there was no significant difference between the two groups （P>0.05）. With regard to the sensitivity， specificity， misdiagnosis rate， missed diagnosis rate， positive predictive rate and negative predictive rate of the FRD and TCT， there were no significant differences between the two detection methods （P>0.05）. Conclusion FRD and TCT both obtain the effects of screening for cervical precancerous lesions， and the diagnostic value is equivalent.

[Key words] Cervical precancerous lesion; Screening; Folate receptor-mediated tumor detection; Liquid-based thin-prep cytology test

宫颈癌是妇产科常见的恶性肿瘤[1]，每年新发病约13.2万，死亡5万[2]，并有年轻化趋势[3-4]。宫颈癌有明显的癌前病变期，而且发展缓慢，但多数患者就诊时已经处于晚期，失去了最佳治疗时机，因此宫颈病变的早期筛查十分重要[5]。尽早发现癌前病变，及时干预是阻断宫颈癌发展的关键，能使发病率与死亡率大大下降[6-7]。液基薄层细胞学（thinprep cytologic test，TCT）是目前先进的筛查技术[8]，虽然其灵敏度高，特异性强，但仍存在较多不足，如要求精密设备仪器及专业技术人员、取材送检程序烦琐、检测费用昂贵、等待结果时长等。为此，寻找经济实用、方便快捷的检测方法是值得探究的问题。本研究采……