胡蓉

【摘要】 目的：探究DNA倍體定量检查联合高危HPV检测在子宫颈鳞状上皮病变患者中的检查价值。方法：收集2019年1月-2020年6月于本院同时行DNA倍体定量和高危HPV检测的患者2 400例，选取其中具有明确病理检查结果的306例子宫颈鳞状上皮病变患者作为研究对象。以病理检查结果为金标准，比较DNA倍体定量检查、高危HPV检测及两者联合检测对高级别鳞状上皮内病变及子宫颈癌的特异度、敏感度、阳性预测值、阴性预测值及约登指数，比较不同子宫颈鳞状上皮病变者的DNA倍体定量检查结果，采用Spearman秩相关分析异倍体细胞数与子宫颈鳞状上皮病变严重程度的关系。结果：联合检测对高级别鳞状上皮内病变及子宫颈癌的敏感度与阴性预测值均高于DNA倍体定量检查及高危HPV检测的结果，差异均有统计学意义（P<0.05），且约登指数最高。不同子宫颈鳞状上皮病变者的>5C及>9C异倍体细胞数比较，差异均有统计学意义（P<0.05）。Spearman秩相关分析显示，>5C及>9C异倍体细胞数与子宫颈鳞状上皮病变严重程度均呈正相关（rs=0.889、0.913，P<0.05）。结论：DNA倍体定量检查联合高危HPV检测对高级别鳞状上皮内病变及子宫颈癌的敏感度与阴性预测值较好，且>5C及>9C异倍体细胞数与子宫颈鳞状上皮病变严重程度均呈正相关，DNA倍体定量检查具有较高的临床应用价值。

【关键词】 DNA倍体定量检查 高危HPV检测 子宫颈鳞状上皮病变

Detection Value of DNA Ploidy Quantitative Test Combined with High-risk HPV Detection in the Patients with Cervical Intraepithelial Neoplasia/HU Rong. //Medical Innovation of China， 2021， 18（16）： 0-074

[Abstract] Objective： To investigate the detection value of DNA ploidy quantitative test combined with high-risk HPV detection in the patients with cervical intraepithelial neoplasia. Method： A total of 2 400 patients who underwent DNA ploidy quantification and high-risk HPV detection at the same time in our hospital from January 2019 to June 2020 were collected， and 306 patients with cervical squamous epithelial lesions with definite pathological examination results were selected as the research objects. With pathologic examination results as the gold standard， the specificity， sensitivity， positive predictive value， negative predictive value and Youden index of DNA ploidy quantification and high-risk HPV detection and the combination of both test for HSIL and cervical cancer were compared. The results of DNA ploidy quantification for different cervical squamous lesion were compared. Spearman rank correlation was used to analyze the relationship between the number of aneuploidy cells and the severity of cervical squamous epithelial lesions. Result： The sensitivity and negative predictive values of the combination test were higher than those of DNA ploidy quantitative test and high-risk HPV test， and the differences were statistically significant （P<0.05）， and Youden index was the highest. There were statistically significant differences in the number of >5C and >9C aneuploidy cells among different cervical squamous epithelial lesions （P<0.05）. Spearman rank correlation analysis showed that the number of >5C and >9C aneuploidy cells were positively correlated with the severity of cervical squamous lesion （rs=0.889， 0.913， P<0.05）. Conclusion： DNA ploidy quantitative test combined with high-risk HPV test has good sensitivity and negative predictive value for HSIL and cervical cancer， and the number of >5C and >9C aneuploidy cells is positively correlated with the severity of cervical squamous lesion. DNA ploidy quantitative test has high clinical application value.

[Key words] DNA ploidy quantitative test High-risk HPV detection Cervical intraepithelial neoplasia

First-author’s address： Shenzhen Baoan District Central Hospital， Shenzhen 518102， China

doi：10.3969/j.issn.1674-4985.2021.16.017

子宫颈鳞状上皮病变是临床研究重点之一，与本病相关的诊治研究多见，其早期有效的诊断是改善预后的必要前提。……