电子阴道镜结合HPV16、18及沙眼衣原体检测对宫颈上皮内瘤样病变的诊断价值

目的　通过对电子阴道镜检查宫颈上皮内瘤样病变(CIN ),以及 HPV16、18 型、沙眼衣原体与 CIN关系的研究,探讨电子阴道镜结合HPV16、18及沙眼衣原体检测对 CIN的诊断价值。方法　采用电子阴道镜观察宫颈形态,PCR法检测宫颈组织中HPV16、18及免疫层析法检测宫颈分泌物中沙眼衣原体(CT),并与病理检查结果对照分析。结果　电子阴道镜诊断CIN的灵敏度为67%,特异度为75%,阳性预测值63%,阴性预测值78%;HPV16、18阳性病例中CIN的发生率显著高于阴性病例,电子阴道镜诊断CIN的准确率在 HPV16、18 阳性病例中显著高于阴性病例,在CT阳性与阴性病例间无显著性差异。结论　电子阴道镜适合作为CIN的诊断方法; HPV16、18 检测可作为诊断CIN的方法之一,与电子阴道镜结合可提高诊断的准确率,电子阴道镜结合CT检测对诊断CIN帮助不大。

The value of colposcopy combined with detection of HPV16, 18 and chlamydia trachomatis in the diagnosis of cervical intraepithelial neoplasia

Objective To evaluate the value of colposcopy combined with detection of HPV16,18 and chlamydia trachomatis in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods Colposcopy was used to examine cervix uteri, and PCR was employed to test HPV16, 18 DNA, and immunoassay to test chlamydia trachomatis (CT). Results The sensitivity of colposcopy in diagnosing CIN was 67%, with the specificity being 75%, and the positive predictive value was 63%, while the negative predictive value was 78%, and the accuracy was 75%. The accuracy of colposcopy in HPV16, 18 positive patients was higher than that in HPV16, 18 negative cases, and no significant difference was shown between CT infected and uninfected cases. Conclusion Colposcopy is a suitable diagnostic approach to screening CIN, and HPV16, 18 detection can be used to diagnose CIN too. While combined with colposcopy, it can improve the accuracy of diagnosis, but the colposcopy combined with CT testing was of little help in the diagnosis of CIN.