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find Author "李征宇" 2 results
  • 宫颈癌诊治中的几个热点问题

    宫颈癌作为女性生殖道最常见的恶性肿瘤,严重威胁女性的身心健康,且近年发病率有所上升。宫颈细胞学检查及人乳头瘤病毒检查是宫颈癌最主要的筛查方法,但如何做到宫颈癌的早期筛查到目前仍无定论。此外,宫颈癌患者的年轻化促使保全患者生育功能的手术方式诞生,但该类手术的适应证及预后都需更深层次地研究。同时近年来关于不同的新型辅助治疗策略的研究也取得了不同程度的进展,而如何选择辅助治疗是临床工作者亟待解决的问题。

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  • The Value of Cervical Fluid-based Cytology Test, High-risk Human Papillomavirus Test, and Colposcopy in Screening Cervical Intraepithelial Neoplasia and Cervical Cancer in High-risk Populations

    ObjectiveTo investigate the screening value of cervical fluid-based cytology test (TCT), high-risk human papillomavirus (HR-HPV) test, and colposcopy for cervical intraepithelial neoplasia (CIN) and cervical cancer in high-risk populations. MethodsA total of 466 patients between January 2013 and January 2015 with a history of intercourse bleeding were enrolled in this study, and the screening value of TCT, HR-HPV test and colposcopy for CIN and cervical cancer were retrospectively evaluated. ResultsIn the 466 patients, 165 were diagnosed with cervical inflammation, 116 with CIN, 182 with grade 2-3 CIN, and 3 with cervical cancer. The colposcopy had the highest sensitivity (84.1%), the lowest specificity (59.4%), high false positive rate (40.6%), low false negative rate (15.9%), and the highest negative predictive value (67.1%). The TCT had the highest specificity (84.8%) and the lowest false positive rate (15.2%). The indicators of HR-HPV were between those of TCT and colposcopy. There were significant differences in terms of these indicators among the three methods (P < 0.05). And the positive prediction value of HR-HPV was the highest (84.5%), while the negative prediction value of colposcopy was the highest (67.1%). There was a significant difference in the predictive value among the three methods (P < 0.05). The consistency of either TCT or HR-HPV alone with pathological diagnosis was poor (K=0.213, 0.343), while that of colposcopy was moderate (K=0.446). Combination of TCT and HR-HPV could significantly improve the diagnosis sensitivity (93.0%) with a lower false negative rate (7.0%); Youden index was 0.736, and the consistency with pathological examination was high (K=0.748). ConclusionsFor high-risk population with a history of intercourse bleeding or other abnormal cervical disorders, the screening sensitivity of TCT and HR-HPV alone for CIN and cervical cancer is low with a high false negative rate. Colposcopy has a high sensitivity and a low specificity. By combination of TCT and HR-HPV, the validity, reliability and predictive values can be improved significantly, and the sensitivity is high with a low false negative rate and a high consistency with pathological examination.

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