TruScreen宫颈癌实时筛查系统在宫颈癌筛查中的价值(1)
【摘要】 目的：探討TruScreen宫颈癌实时筛查系统对宫颈癌筛查的价值。方法：对在北京市大兴区人民医院妇产科门诊的292例患者依次行TruScreen(TS)、细胞学(TCT)、高危亚型HPV筛查，对于结果为TruScreen异常、细胞学阳性(≥ASCUS)或高危亚型HPV阳性的83例患者行阴道镜检查及宫颈活检术，以宫颈活检术的结果即组织病理学结果为金标准，从而验证TS对宫颈癌前病变(≥LSIL)的筛查价值。结果：83例患者行宫颈组织病理学检查，43例病理结果异常(≥LSIL)，宫颈病变总发病率为14.73%(43/292)，TruScreen检测结果异常46例，病变检出阳性率为15.75%(46/292)；TS病变检出阳性率与总发病率接近。TCT、HPV及TS三项检查结果均正常患者209例，三者结果均阳性28例，三者检查一致率为81.16%(237/292)；TCT检测宫颈病变敏感度为81.40%(35/43)，特异度为93.57%(233/249)，HPV检测宫颈病变敏感度为86.05%(37/43)，特异度为89.16%(222/249)，TS检测宫颈病变敏感度为86.05%(37/43)，特异度为96.39%(240/249)，三种检测方法中HPV及TS检出宫颈病变敏感性高于TCT组，且TS检测宫颈病变特异性明显高于HPV及TCT组。TS在宫颈鳞状上皮内低度病变的敏感性为75.00%(15/20)，在上皮内高度病变的敏感度为95.45%(21/22)。TS的筛查结果与病理学结果比较，差异无统计学意义(P>0.05)。如果TS联合TCT、TS联合HPV或三者联合检测，宫颈病变检测特异性明显增加。结论：TruScreen与病理学诊断有较好的一致性，TruScreen可以尝试在普通综合医疗机构作为宫颈癌筛查的另一种选择。
【关键词】 TruScreen； TCT； HPV； 宫颈病变
The Value of TruScreen Cervical Cancer Real-time Screening System in Cervical Cancer Screening/HE Xiao-qian，MA Xiu-hua，GAO Wan-li，et al.//Medical Innovation of China，2017，14(27)：070-074
【Abstract】 Objective：To investigate the value of TruScreen cervical cancer real-time screening system in cervical cancer screening.Method：TruScreen(TS)，cytology(TCT) and high-risk subtype HPV screening were performed in 292 patients in the department of gynaecology and obstetrics clinic in Beijing Daxing People’s Hospital，the results of TruScreen abnormal cytology positive (more than ASCUS) or high-risk subtypes of 83 HPV positive patients underwent colposcopy and cervical biopsy，the cervical biopsy results that the pathology results as the gold standard，in order to verify the TS of cervical precancerous lesion (more than LSIL) the value of screening.Result：83 patients with cervical histopathological examination，43 cases of abnormal pathological results (≥LSIL)，total incidence of cervical lesions was 14.73% (43/292)，TruScreen test resulted in 46 abnormal cases，with a positive rate of 15.75%(46/292)；the positive rates of TruScreen and total incidence of cervical lesions were similar.TCT，HPV and TS were all found to have 209 normal patients，all of which were positive in 28 cases，with a unanimous rate of 81.16%(237/292).The sensitivity of TCT，HPV，TS respectively was 81.40%(35/43)，86.05%(37/43)，86.05%(37/43) and the speciality respectively was 93.57%(233/249)，89.16%(222/249)，96.39% (240/249).In the three tests，HPV and TS were found to be more sensitive to cervical lesions than TCT，and TS were significantly more specific to cervical lesions than HPV and TCT.The sensitivity of TS to LSIL and HSIL respectively was 75.00%(15/20) and 95.45%(21/22).The differences between the findings of the TS and the pathological results had no statistical significance(P>0.05).If TS combined TCT or HPV，or three joint tests，the detection specificity of cervical lesions increased significantly.Conclusion：TruScreen has a good agreement with pathological diagnosis，TruScreen can be used as an alternative to cervical cytology in general general health care., 百拇医药(贺笑茜 马秀华 高万里 宋风丽 刘春霞 吴慷杰)
【关键词】 TruScreen； TCT； HPV； 宫颈病变
The Value of TruScreen Cervical Cancer Real-time Screening System in Cervical Cancer Screening/HE Xiao-qian，MA Xiu-hua，GAO Wan-li，et al.//Medical Innovation of China，2017，14(27)：070-074
【Abstract】 Objective：To investigate the value of TruScreen cervical cancer real-time screening system in cervical cancer screening.Method：TruScreen(TS)，cytology(TCT) and high-risk subtype HPV screening were performed in 292 patients in the department of gynaecology and obstetrics clinic in Beijing Daxing People’s Hospital，the results of TruScreen abnormal cytology positive (more than ASCUS) or high-risk subtypes of 83 HPV positive patients underwent colposcopy and cervical biopsy，the cervical biopsy results that the pathology results as the gold standard，in order to verify the TS of cervical precancerous lesion (more than LSIL) the value of screening.Result：83 patients with cervical histopathological examination，43 cases of abnormal pathological results (≥LSIL)，total incidence of cervical lesions was 14.73% (43/292)，TruScreen test resulted in 46 abnormal cases，with a positive rate of 15.75%(46/292)；the positive rates of TruScreen and total incidence of cervical lesions were similar.TCT，HPV and TS were all found to have 209 normal patients，all of which were positive in 28 cases，with a unanimous rate of 81.16%(237/292).The sensitivity of TCT，HPV，TS respectively was 81.40%(35/43)，86.05%(37/43)，86.05%(37/43) and the speciality respectively was 93.57%(233/249)，89.16%(222/249)，96.39% (240/249).In the three tests，HPV and TS were found to be more sensitive to cervical lesions than TCT，and TS were significantly more specific to cervical lesions than HPV and TCT.The sensitivity of TS to LSIL and HSIL respectively was 75.00%(15/20) and 95.45%(21/22).The differences between the findings of the TS and the pathological results had no statistical significance(P>0.05).If TS combined TCT or HPV，or three joint tests，the detection specificity of cervical lesions increased significantly.Conclusion：TruScreen has a good agreement with pathological diagnosis，TruScreen can be used as an alternative to cervical cytology in general general health care., 百拇医药(贺笑茜 马秀华 高万里 宋风丽 刘春霞 吴慷杰)