HPV宫颈癌检出率影响因素及阴道体外定性HPV-DNA检测在HPV16/18分流筛查中的应用

    Influencing Factors of HPV 16/18 Cervical Cancer Detection Rate and Application Effect of Vaginal In Vitro Qualitative HPV-DNA Detection Screening Model

    • 摘要:
      目的 探讨人乳头瘤病毒(human papillomavirus,HPV)宫颈癌检出率影响因素及阴道体外定性HPV-DNA检测在HPV16/18分流筛查中的应用。
      方法 采用分层整群随机抽样的横断面调查方法对5 217例体外定性HPV-DNA核酸检测患者检测结果进行分析。记录患者临床资料,分析影响HPV宫颈癌阳性检出率的危险因素。基于危险因素构建列线图模型并利用受试工作者(receiver operating characteristic,ROC)曲线和校准曲线评价模型的应用效果。
      结果 5 217例患者经阴道体外定性HPV宫颈癌筛查并经阴道镜病理诊断检查,结果显示,HPV真阳性2 187例,真阴性2 248例,假阳性495例,假阴性287例;准确性为85.01%,敏感性为88.40%,特异性为81.95%,阳性预测值为81.54%,阴性预测值为88.68%。年龄 > 45岁,伴有糖尿病、高血压、高血脂、子宫内膜炎、乳腺增生、阴道炎、卵巢囊肿、乳腺炎的阳性检出率较高,是HPV-DNA宫颈癌结果阳性检出率的影响因素。ROC曲线下和校准曲线显示模型应用效果良好。
      结论 阴道体外定性阴道体外定性HPV-DNA宫颈癌筛查具有较高的准确性,可应用于分流筛查HPV16/18分型。

       

      Abstract:
      Objective To explore the factors influencing the detection rate of human papillomavirus (HPV) cervical cancer and the application of in vitro qualitative HPV-DNA test in HPV16/18 shunt screening.
      Methods The results of 5 217 patients with in vitro qualitative HPV-DNA nucleic acid testing were analyzed by stratified cluster random sampling cross-sectional investigation. The clinical data of patients were recorded and the risk factors affecting the positive detection rate of HPV cervical cancer were analyzed. The nomogram model was constructed based on the risk factors, and the application effect of the model was evaluated by the receiver operating characteristic (ROC) curve and calibration curve.
      Results A total of 5 217 patients were screened by vaginal in vitro qualitative HPV cervical cancer screening mode and pathological diagnosis by colposcopy. The results showed that there were 2 187 true positive cases, 2 248 true negative cases, 495 false positive cases, and 287 false negative cases. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of HPV were 85.01%, 88.40%, 81.95%, 81.54%, and 88.68%, respectively. Age > 45 years, diabetes mellitus, hypertension, hyperlipidemia, endometritis, mammary hyperplasia, vaginitis, ovarian cysts, and mastitis influenced the positive detection rate of HPV-DNA cervical cancer. The ROC curve and calibration curve showed that the model had a good application effect.
      Conclusions In vitro vaginal HPV DNA cervical cancer screening has high accuracy and can be used in shunt screening for HPV16/18 types.

       

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