张艳萍, 吴瑞芳, 刘志红, 汤惠茹, 王纯, 周艳秋. LCT联合HR-HPV检测在宫颈上皮内瘤变Ⅲ级LLETZ术后随访中的价值[J]. 中国肿瘤临床, 2013, 40(11): 657-660. DOI: 10.3969/j.issn.1000-8179.2013.11.010
引用本文: 张艳萍, 吴瑞芳, 刘志红, 汤惠茹, 王纯, 周艳秋. LCT联合HR-HPV检测在宫颈上皮内瘤变Ⅲ级LLETZ术后随访中的价值[J]. 中国肿瘤临床, 2013, 40(11): 657-660. DOI: 10.3969/j.issn.1000-8179.2013.11.010
shu
Yanping ZHANG, Ruifang WU, Zhihong LIU, Huiru TANG, Chun WANG, Yanqiu ZHOU. Value of liquid-based cytology test combined with HR-HPV testing in CIN Ⅲ after LLETZ during follow-up[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(11): 657-660. DOI: 10.3969/j.issn.1000-8179.2013.11.010
Citation: Yanping ZHANG, Ruifang WU, Zhihong LIU, Huiru TANG, Chun WANG, Yanqiu ZHOU. Value of liquid-based cytology test combined with HR-HPV testing in CIN Ⅲ after LLETZ during follow-up[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(11): 657-660. DOI: 10.3969/j.issn.1000-8179.2013.11.010
shu

LCT联合HR-HPV检测在宫颈上皮内瘤变Ⅲ级LLETZ术后随访中的价值

Value of liquid-based cytology test combined with HR-HPV testing in CIN Ⅲ after LLETZ during follow-up

    摘要
  • 摘要:
      目的  评价HR-HPV(high-risk human papillomavirus)检测在CINⅢ(cervical intraepithelial neoplasia gradeⅢ)行宫颈移行区大环切除术(LLETZ)后随访中的价值。
      方法  采用临床病例分析的方法, 选取北京大学深圳医院2003年5月至2009年5月间诊断为CINⅢ接受LLETZ(large loop excision of the transformation zone)手术的567例患者, 术后3、6个月及以后每6~12个月随访1次, 以LCT(liquid-based cytologic test)及HCⅡ(hybrid captured-Ⅱ)法HR-HPV DNA检测作为随访的监测指标, 评估LCT联合HR-HPV检测在术后随访中的价值。
      结果  1) 术后LCT预测病变残留灵敏度60.00%, 特异度88.15%, 阳性预测值8.30%, 阴性预测值99.19%;HPV预测病变残留灵敏度100%, 特异度85.64%, 阳性预测值11.11%, 阴性预测值100%;LCT预测病变复发灵敏度63.64%, 特异度92.27%, 阳性预测值14.00%, 阴性预测值99.23%;HPV预测病变复发灵敏度72.73%, 特异度85.97%, 阳性预测值9.30%, 阴性预测值99.38%。2)术后HPV持续阳性患者复发几率高于非HPV持续感染患者, 差异有统计学意义(P < 0.05)。术后复发率在HPV持续阳性组与再次感染组为高, HPV持续阴性组术后无复发。
      结论  术后LCT联合HR-HPV检测预测残留或复发有重要价值, 是一种有效的随诊方法。术后HPV感染状态与复发相关, 临床需严密随访。

     

    Abstract:
      Objective  This study aimed to evaluate the value of liquid-based cytology test(LCT)combined with high-risk human papillomavirus(HR-HPV)testing in cervical intraepithelial neoplasia grade Ⅲ(CIN Ⅲ)after large-loop excision of the transformation zone(LLETZ)during follow-up.
      Methods  Clinical analysis was used to investigate 567 patients diagnosed with CIN Ⅲ and treated with LLETZ from May 2003 to May 2009 at Peking University Shenzhen Hospital.The patients were enrolled in a follow-up program set at 3 months, 6 months, and every 6 to 12 months.LCT and HR-HPV testing were used as monitoring indicators to evaluate HR-HPV testing after LLETZ during follow-up.
      Results  1) The residual lesion predicting capacity of postoperative LCT obtained the following: sensitivity, 60%: specificity, 88.15%: positive predictive value, 8.30%;and negative predictive value, 99.19%.The residual lesion predicting capacity of HPV testing obtained the following: sensitivity, 100%: specificity, 85.64%: positive predictive value, 11.11%;and negative predictive value, 100%.The recurrent lesion predicting capacity of postoperative LCT obtained the following: sensitivity, 63.64%;specificity, 92.27%;positive predictive value, 14.00%;and negative predictive value, 99.23%.The recurrent lesion predicting capacity of HPV testing obtained the following: sensitivity, 72.73%;specificity 85.97%;positive predictive value 9.30%;and negative predictive value, 99.38%.2)The recurrent lesion rate was higher in postoperative persistent HPV infection patients than in non-postoperative persistent HPV infection patients, Ther were statistically significant differences between the persistent negative and non-testing preoperative group(P < 0.05).The recurrence rate was higher in persistent HPV-positive and HPV-re-infected patients than in the negative conversion group, whereas no recurrent lesion was found in persistent HPV-negative patients.
      Conclusion  Resultsshowed the importance of predicting residual and recurrent lesions by LCT and HR-HPV testing, which were also confirmed to be effective methods in follow up.Postoperative persistent HPV-positive status is associated with recurrence and requires consistent follow-up.

     

    • HTML全文
    • 参考文献(15)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回