摘要【目的】探讨Aptima-HPV和cobas-HPV检查在宫颈细胞学检测意义不明的不典型鳞状细胞(ASC-US)中的应用价值。【方法】选择2017年3月至2020年9月在本院接受液基细胞学检查并确诊为ASC-US患者1328例作为研究对象,所有患者均采用Aptima-HPV和cobas-HPV检测,一致性分析采用κ系数,采用受试者工作曲线(ROC)计算两种检测方法的敏感性、特异性,采用McNemar检验aptima-HPV和cobas-HPV检测＜CINⅡ、CINⅡ、CINⅢ+的差异。【结果】cobas-HPV对高风险人乳头瘤病毒(high-risk human papillomavirus,hrHPV)检测阳性率高于aptima-HPV检测(45.33％ vs 41.94％,P<0.05),总符合率为90.89％,二者具有良好的一致性,κ=0.82。CINⅢ+患者aptima-HPV和cobas-HPV检测hrHPV的阳性率分别为96.43％和92.86％;CINⅡ组患者aptima-HPV和cobas-HPV检测hrHPV的阳性率分别为84.51％和87.32％,CINⅡ和CINⅢ+患者中aptima-HPV和cobas-HPV检测阳性率比较差异无统计学意义(P>0.05)。aptima-HPV和cobas-HPV诊断CINⅢ+的灵敏度比较差异无统计学意义(P>0.05);aptima-HPV诊断特异性高于cobas-HPV,其差异有统计性意义(P<0.05)。aptima-HPV和cobas-HPV诊断CINⅢ+的灵敏度比较差异无统计学意义(P>0.05);aptima-HPV诊断特异性高于cobas-HPV,差异有统计学意义(P<0.05)。aptima-HPV和cobas-HPV基因型检测具有良好的一致性(κ=0.80,P<0.05),aptima-HPV和cobas-HPV对CINⅡ患者检测具有良好一致性(κ=0.79,P<0.05)。【结论】aptima-HPV和cobas-HPV检测hrHPV和风险分层具有可比性,对CINⅡ和CINⅢ+敏感度相似,但aptima-HPV较cobas-HPV更具特异性。
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2021, Vol. 38 
