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Abstract：
In the present study, the diagnostic value of high risk-human papillomavirus (HR-HPV) combined with colposcopy for the detection of cervical cancer and precancerous lesions was evaluated. A total of 397 patients with confirmed cervical disease were enrolled between August 2020 and December 2021. According to the pathological diagnosis, the patients were divided into cervical intraepithelial neoplasia grade I (CIN I; n=153 cases), CIN II (n=101 cases), CIN III (n=86 cases) and cervical cancer (n=57 cases) groups. The HR-HPV-positive rate of the patients with different lesion types was compared, and the consistency of colposcopy and pathological examination results were assessed. For cervical cancer and precancerous lesions, the diagnostic value and efficacy of HR-HPV testing, colposcopy and combined HR-HPV testing and colposcopy examination were compared using pathological examination results as the gold standard. The results of the present study demonstrated that in patients with cervical cancer, the positive rate of HR-HPV (100.00%; n=57/57) was higher than that in patients with precancerous lesions, and the positive rate of HR-HPV in patients with CIN I type (36.60%, n=56/153) was lower than that in patients with CIN II (83.17%, n=84/101) and CIN III (82.56%, n=71/86) types (P<0.05). There was no significant difference in the HR-HPV-positive rate between patients with CIN II and CIN III (P>0.05). Cohen\'s κ coefficient for colposcopy examination and pathological examination of patients with cervical cancer and precancerous lesions was 0.622, the diagnostic accuracy was 90.43% (n=359/397), the positive predictive value was 65.57% (n=40/61), and the negative predictive value was 94.94% (n=319/336). Receiver operating characteristic curve analysis demonstrated that the area under the curve of the combined examination in the diagnosis of cervical cancer and precancerous lesions was 0.904, which was higher than that of colposcopy (0.820) or HR-HPV testing (0.802) alone (P<0.05). The results of the present study indicated that HR-HPV detection combined with colposcopy has diagnostic value for cervical cancer and precancerous lesions.
摘要：
在本研究中,评价高危型人乳头瘤病毒(HR-HPV)联合阴道镜检查对宫颈癌及癌前病变的诊断价值.在2020年8月至2021年12月期间，共招募了397名确诊宫颈疾病的患者。根据病理诊断,将患者分为宫颈上皮内瘤变I级（CINI；n=153例），CINII（n=101例），CINⅢ组(n=86例)和宫颈癌组(n=57例)。比较不同病变类型患者的HR-HPV阳性率,评估阴道镜检查结果与病理检查结果的一致性。对于宫颈癌和癌前病变，HR-HPV检测的诊断价值和疗效，以病理检查结果为金标准，比较阴道镜检查和HR-HPV联合检测及阴道镜检查。本研究的结果表明，在宫颈癌患者中，HR-HPV阳性率(100.00%;n=57/57)高于癌前病变患者,CINI型患者的HR-HPV阳性率（36.60％，n=56/153)低于CINII患者(83.17%，n=84/101）和CINIII（82.56%，n=71/86)型(P<0.05)。CINII和CINIII患者的HR-HPV阳性率差异无统计学意义（P>0.05）。宫颈癌及癌前病变患者阴道镜检查和病理检查的Cohen\sκ系数为0.622,诊断准确率为90.43%(n=359/397),阳性预测值为65.57%(n=40/61)，阴性预测值为94.94%(n=319/336)。受试者工作特征曲线分析表明，联合检查诊断宫颈癌及癌前病变的曲线下面积为0.904，高于单纯阴道镜检查（0.820）或HR-HPV检测（0.802）（P<0.05）。提示HR-HPV检测联合阴道镜检查对宫颈癌及癌前病变具有诊断价值。
