关键词: 绝经后妇女, 宫颈癌, 机会性筛查, 宫颈液基薄层细胞检测, 高危型人乳头状瘤病毒, 联合筛查

Abstract: OBJECTIVE： To investigate the usefulness of thin-prep cytologic test (TCT) combined with high-risk human papilloma virus (HR-HPV) detection in opportunistic screening for cervical cancer in community postmenopausal women. METHODS： The clinical data of 698 community postmenopausal women who underwent opportunistic screening for cervical cancer from November 2021 to December 2024 were collected in this study， and these women were given TCT and HR-HPV detection. Among them， 165 individuals with abnormal screening results underwent colposcopy at a higher-level hospital. Finally， the sensitivity， specificity and accuracy of TCT， HR-HPV and their combined detection were compared and analyzed with colposcopy biopsy as the gold standard. The receiver operating characteristic (ROC) curve was used to analyze diagnostic performance. RESULTS： The sensitivities of TCT and HR-HPV testing were 91.11% and 92.22%，respectively，both with a specificity of 48.0%，positive predictive values of 67.77% and 68.03% ， negative predictive values of 81.82% and 83.72% ， and accuracies of 71.52% and 72.12% . The combined detection sensitivity of the two methods was 97.78% ， specificity was 45.33% ， positive predictive value was 68.22%，negative predictive value was 94.44%，and accuracy was 73.94%. The accuracy of TCT and HR-HPV testing alone was lower than that of the combined testing；the area under the ROC curve for combined testing in cervical cancer screening was higher than that of TCT or HPV alone (P<0.05). CONCLUSION： TCT combined with HR-HPV detection showed high diagnostic efficacy，improved sensitivity of cervical cancer screening， and higher clinical value for opportunistic cervical cancer screening in postmenopausal women.

Key words: postmenopausal women, cervical cancer, opportunistic screening, thin-layer liquid-based cytology test, high-risk human papillomavirus, combined screening