巴氏涂片和聚合酶链反应试验在巴林筛查人乳头瘤病毒的比较研究。

IF 1.9
Nermin Kamal Saeed, Safa Alshaikh, Mohammed Al-Beltagi
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引用次数: 0

摘要

背景:宫颈癌仍然是一个全球健康问题,特别是在包括巴林在内的低收入和中等收入国家,人乳头瘤病毒(HPV)感染是主要原因。目的:比较宫颈细胞学(巴氏涂片)和聚合酶链反应(PCR)分子HPV检测对巴林妇女宫颈异常的诊断准确性。方法:我们回顾性分析了来自Salmaniya医学综合实验室的320份巴氏涂片样本。细胞学结果与HPV PCR结果进行比较,以PCR检测为金标准。计算敏感性、特异性、阳性预测值和阴性预测值。统计分析包括卡方检验和费雪精确检验。结果:320份标本中,hpv阳性56例(17.5%),hpv阴性264例(82.5%)。PCR的敏感性较高(95.5%),但中度特异性较低(67.4%),对组织病理病变的阳性预测值为94.6%,阴性预测值为96.9%。巴氏涂片检出57.5%的上皮内病变或恶性肿瘤呈阴性,42.5%有异常。hpv阳性病例细胞学异常率较高,尽管细胞学结果正常,但组织病理学证实一些hpv阳性病例有病变。结论:HPV PCR联合巴氏涂片检测可提高宫颈癌的检出率。建议根据个别危险因素制定有针对性的筛查方案,以减轻疾病负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative study of pap smear and polymerase chain reaction tests for human papillomavirus screening in Bahrain.

Background: Cervical cancer remains a global health concern, particularly in low- and middle-income countries, including Bahrain, where human papillomavirus (HPV) infection is the leading cause.

Aim: To compare the diagnostic accuracy of cervical cytology (pap smear) and molecular HPV detection using polymerase chain reaction (PCR) in identifying cervical abnormalities among women in Bahrain.

Methods: We retrospectively analysed 320 pap smear samples from the Salmaniya Medical Complex laboratory. Cytological findings were compared with HPV PCR results, using PCR testing as the gold standard. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analyses included chi-square and Fisher's exact tests.

Results: Among the 320 samples, 56 (17.5%) were HPV-positive and 264 (82.5%) were HPV-negative. PCR showed higher sensitivity (95.5%) but had reduced moderate specificity (67.4%), with a positive predictive value for detecting histopathological lesions of 94.6% and a negative predictive value of 96.9%. Pap smears identified 57.5% as negative for intraepithelial lesion or malignancy and 42.5% with abnormalities. HPV-positive cases had higher abnormal cytology rates, and histopathology confirmed lesions in some HPV-positive cases despite normal cytology results.

Conclusion: Combining HPV PCR with pap smear enhances cervical cancer detection. Tailored screening programmes based on individual risk factors are recommended to reduce the disease burden.

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