宫颈上皮细胞稳定性游离亚铁原卟啉检测在不同年龄段宫颈癌诊断中的意义
[摘要] 目的 探討宫颈上皮细胞稳定性游离亚铁原卟啉（FH）检测在不同年龄段宫颈癌诊断中的意义。 方法 回顾性分析湖南省脑科医院2014年10月～2017年10月收治的213例宫颈肿瘤患者的临床资料，将其按年龄分为≤30岁、>30～40岁、>40～50岁、>50～60岁、>60～70岁及>70岁6个年龄段，均行手术治疗且均经病理检测明确诊断，另均行上皮细胞稳定性FH检测。对比不同年龄段FH检测结果，分析不同年龄段FH检测的灵敏度、特异度及准确度，并绘制基于上皮稳定性FH的检测结果在不同年龄段宫颈肿瘤患者中的工作曲线（ROC），得出曲线下面积（AUC）。 结果 >40～50岁者与>60～70岁者的总阳性率均明显高于≤30岁、>30～40岁、>50～60岁及>70岁者（P < 0.05），但其他各年龄段两两比较差异无统计学意义（P > 0.05）；宫颈上皮细胞稳定性FH染色检测≤30岁、>30～40岁、>40～50岁、>50～60岁、>60～70岁及>70岁宫颈癌患者分别有10、25、56、9、50例及11例，而病理学诊断则分别有7、21、55、7、49例及8例；不同年龄段宫颈肿瘤患者进行上皮细胞稳定性FH检测均具有较高的灵敏度、特异度及准确度，但>40～50岁与>60～70岁者高于其他年龄段；上皮细胞稳定性FH检测>40～50岁、>60～70岁、>30～40岁、>70岁、>50～60岁及≤30岁的AUC分别为0.956、0.949、0.819、0.763、0.727及0.725。 结论 宫颈上皮细胞稳定性FH检测在不同年龄段宫颈癌诊断中均具有一定的可靠性，但在>40～50岁与>60～70岁者中灵敏度、特异度及准确度相对较高，可用于指导临床宫颈癌筛查及诊断。
[关键词] 宫颈上皮细胞稳定性游离亚铁原卟啉；宫颈癌；年龄段
[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0110-05
Significance of detection of cervical epithelial cell stability free ferrous protoporphyrin in the diagnosis of cervical cancer in different ages
ZHAO Ying ZHOU Xunhua CHEN Yanhui
Department of Gynecology and Obstetrics， Hu"nan Brain Hospital， Hu"nan Province， Changsha 410007， China
[Abstract] Objective To investigate the significance of detection of cervical epithelial cell stability free ferrous protoporphyrin （FH） in the diagnosis of cervical cancer in different ages. Methods The clinical data of 213 cases of patients with cervical tumor admitted to Hu"nan Brain Hospital from October 2014 to October 2017 was retrospectively analyzed. They were divided into 6 age groups of ≤30 years old， >30-40 years old， >40-50 years old， >50-60 years old， >60-70 years old， and >70 years old by age， and all the patients were treated with surgical treatment and diagnosed by pathological examination， also they were detected by cervical epithelial cells stability FH. The results of FH detection at different ages were compared， and the sensitivity， specificity and accuracy of FH test in different age groups were analyzed， then the receiver operating curves （ROC） of patients with high-risk cervical cancer in different age groups based on uterine epithelial cells stability FH were made， and the area under curves （AUC） were obtained. Results The total positive rates of people at age of >40-50 years old and >60-70 years old were significantly higher than those of ≤30 years old， >30-40 years old， >50-60 years old and >70 years old （P < 0.05）， but there were no significant differences between the other age groups （P > 0.05）. There were respectively 10， 25， 56， 9， 50 cases and 11 cases of ≤30 years old， >30-40 years old， >40-50 years old， >50-60 years old， >60-70 years old and >70 years old by cervical epithelial cells stability FH， while there were respectively 7， 21， 55， 7， 49 cases and 8 cases of ≤30 years old， >30-40 years old， >40-50 years old， >50-60 years old， >60-70 years old and >70 years old by immunocytochemistry examination. Epithelial cells stability FH detection had higher sensitivity， specificity and accuracy in different age groups， which of >40-50 years old and >60-70 years old were higher than other age groups. The AUC of the uterine epithelial cells stability FH for the detection of people at age of >40-50 years old， >60-70 years old， >30-40 years old， >70 years old， >50-60 years old， and ≤30 years old were 0.956， 0.949， 0.819， 0.763， 0.727 and 0.727 respectively. Conclusion Cervical epithelial cells stability FH staining are reliable in the diagnosis of cervical cancer at different ages， but the sensitivity， specificity and accuracy of >40-50 years old and >60-70 years old are relatively higher other ages， which can be used to guide clinical screening and diagnosis of cervical cancer.