高危型人乳头状瘤病毒检测在子宫颈癌筛查中的意义

    The significance of high-risk human papilloma virus detection in cervical cancer screening

    • 摘要: 目的:探讨高危型人乳头状瘤病毒(HR-HPV)检测在子宫颈癌筛查中的意义。方法:对2 442例子宫颈疾病患者进行液基细胞学(TCT)检测,2 147例患者进行HPV杂交捕获法二代或核酸分子快速导流杂交技术检测(HPV检测),其中783例患者同时进行TCT和HPV检测。723例因细胞学异常或细胞学正常而HR-HPV检测阳性,或细胞学正常HR-HPV阴性临床高度怀疑病变的患者行阴道镜下多点活检、宫颈电圈切除术(LEEP),结合病理结果进行分析。结果:TCT联合HPV检测的样本中,TCT正常或炎症、不能明确意义的非典型鳞状上皮细胞(不除外高度病变非典型鳞状上皮细胞5例,合并计算)、低度鳞状上皮内瘤变、高度鳞状上皮内瘤变的HR-HPV阳性率分别为22.39%、48.09%、74.47%和88.46%,差异有统计学意义(P0.01);随着细胞学诊断级别的升高,HR-HPV阳性率显著上升。阴道镜下多点活检、LEEP病理结果:正常或炎症组、宫颈上皮内瘤变(CIN)1、CIN 2、CIN 3、鳞状细胞癌和湿疣中HR-HPV阳性率分别为23.72%、83.87%、85.19%、88.10%、92.86%、72.37%,差异有统计学意义(P0.01)。结论:持续的HR-HPV阳性与宫颈病变的演进有关,HR-HPV检测在子宫颈癌筛查中具有重要意义。

       

      Abstract: Objective: To explore the significance of high-risk human papilloma virus( HR-HPV) detection in cervical cancer screening. Methods: Two thousand four hundred and forty-two patients were detected using liquid base cytology( TCT),2 147 patients were detected by HPV hybrid capture method of the second generation( HPV-HC Ⅱ) or nucleic acid molecular hybridization technique,TCT and HPV testing of which 783 patients were simultaneously detected. HR-HPV testing in 723 cases with normal or abnormal cytology were positive,the patients with normal cytology,negative HR-HPV and clinical highly suspected lesions were treated with multipoint biopsy under colposcope and cervical electric ring resection( LEEP),these data combined with pathological results were analyzed. Results: Amony samples with TCT and HPV testing,the HR-HPV positive rates in normal or inflammation TCT,ASC-US,lowgrade squamous intraepithelial lesion and high-grade squmous intraepithelial lesion were 22. 39%,48. 09%,74. 47% and 88. 46%, respectively,the difference of which was statistical significance( P 0. 01). The HR-HPV positive rate increased significantly with the increasimg of cytology diagnosis level. LEEP pathological results showed the HR-HPV positive rates in normal or inflammation tissue, cervical intraepithelial neoplasia( CIN) 1,CIN 2,CIN 3,squamous cell carcinoma and condyloma were 23. 72%,83. 87%,85. 19%, 88. 10%,92. 86% and 72. 37%,respectively,the difference of which was statistical significant( P 0. 01). Conclusions: The continuous HR-HPV positive is related to the evolution of cervical lesions,the HR-HPV detection has important significant in screening cervical cancer.

       

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