标题：HR-HPV检测在CINⅢ行宫颈移行区大环切除术后的随访价值

      作者：王勇 1，申鸿 2，张力 3，曾艳 3    1.西安北车医院检验科，陕西 西安 710086；2.西安交通大学医院检验科，陕西 西安 710049；3.陕西省友谊医院检验科，陕西 西安 710068

      卷次： 2019年30卷16期

      【摘要】 目的 分析高危型人乳头瘤病毒(HR-HPV)检测在宫颈上皮内瘤变(CIN)Ⅲ行宫颈移行区大环切除术(LLETA)后的随访价值。方法 回顾性分析2015年9月至2018年1月间在西安北车医院经过病理诊断和宫颈活检确诊为CINⅢ级并行LLETZ手术的113例患者的临床资料，术后对患者每三个月随访一次，共随访四次，建立随访档案，以HCⅡ法HR-HPV和液基细胞学(LCT)检测作为监测指标，评估HR-HPV结合LCT检测对患者术后的随访价值。结果 术后LCT预测病变残留特异度为 88.16%，灵敏度为 60.03%，阴性预测值为 99.20%，阳性预测值为8.28%；HR-HPV对病变残留预测特异度为85.65%，灵敏度为100.0%，阴性预测值为100.0%，阳性预测值为11.09%；LCT对病变复发预测特异度为92.30%，灵敏度为63.59%，阴性预测值为99.19%，阳性预测值为14.02%；HR-HPV对病变复发预测特异度为86.01%，灵敏度为72.68%，阴性预测值为99.40%，阳性预测值为9.28%；术后HR-HPV连续阳性患者病变复发和残留率分别为13.33%、12.50%，明显高于HR-HPV阴性的1.05%、0，差异均有统计学意义(P<0.05)。结论 HR-HPV结合LCT检测对病变复发、残留有重要预测价值，是患者有效随诊方法；患者手术后HPV感染状况和复发有密切联系。
      【关键词】 宫颈上皮内瘤变；宫颈移行区大环切除术；液基细胞学检测；高危型人乳头瘤病毒；随访价值；复发率
      【中图分类号】 R713.4+4 【文献标识码】 A 【文章编号】 1003—6350（2019）16—2088—04

Follow-up value of HR-HPV test in patients with cervical intraepithelial neoplasia (Ⅲ) treated by large loopexcision of the transformation zone.
WANG Yong 1, SHEN Hong 2, ZHANG Li 3, ZENG Yan 3. 1. Department ofLaboratory, Xi'an Beiche Hospital, Xi'an 710086, Shaanxi, CHINA; 2. Department of Laboratory, School Hospital of Xi'anJiaotong University, Xi'an 710049, Shaanxi, CHINA; 3. Department of Laboratory, Shaanxi Friendship Hospital, Xi'an710068, Shaanxi, CHINA
【Abstract】 Objective To analyze the follow-up value of high-risk human papillomavirus (HR-HPV) test in pa-tients with cervical intraepithelial neoplasia (CIN)Ⅲ treated by large loop excision of the transformation zone (LLETZ).Methods A retrospective analysis was performed on clinical data of 113 patients, who were diagnosed as CINⅢ bypathological diagnosis and cervical biopsy and who underwent LLETZ surgery at Xi'an Beiche Hospital from September2015 to January 2018. Patients were followed up every three months for a total of four visits. Follow-up files were estab-lished. HCⅡ HR-HPV and liquid-based cytological test (LCT) were used as monitoring indicators to evaluate the fol-low-up value of HR-HPV test combined with LCT. Results For postoperative LCT predicting residual lesions, the spec-ificity was 88.16%, the sensitivity was 60.03%, the negative predictive value was 99.20%, and the positive predictive val-ue was 8.28%. Applying HR-HPV test for residual disease prediction, the specificity was 85.65%, the sensitivity was