广东妇女人乳头瘤病毒感染及宫颈细胞学的对照研究  

A comparison of human papillomavirus detection and ThinPrep cytology test for women in Guangdong province

作　　者：薛耀华[1] 陈子祥[1] 郑宝文[1] 张建明[1] 朱庆义[1] 

机构地区：[1]广州医学院金域医学检验中心

出　　处：《中华肿瘤杂志》2005年第5期283-285,共3页Chinese Journal of Oncology

摘　　要：目的探讨人乳头瘤病毒(HPV)与宫颈癌的相关性及HPV检测在宫颈癌筛查中的应用。方法用第二代杂交捕获法(HCⅡ)检测2636名妇女宫颈刷出物中13种高危型HPV,其中454例同时做宫颈脱落细胞液基薄层细胞学检测(TCT)。细胞学诊断采用Bethesda分级系统(TBS)。结果2636名妇女高危型HPV感染率为26.5%,其中20岁以下(含20岁)年龄组的高危型HPV感染率最高(59.4%),41～50岁年龄组最低(21.0%)。新会地区HPV感染率显著低于东莞、深圳和广州(P<0.01)。16例宫颈癌患者HPV感染率为93.8%,显著高于健康体检者(19.2%)和宫颈炎患者(30.8%,P<0.001)。454例同时做TCT检查的妇女中,鳞状细胞癌(SCC)、高度鳞状上皮内瘤变(HSIL)、低度鳞状上皮内瘤变(LSIL)、不典型鳞状细胞(ASC)的高危型HPV检出率分别为100%(2/2)、100%(12/12)、88.9%(16/18)和37.8%(28/74)。HPV阳性检出率随病变的严重程度而显著增加。结论高危型HPV是宫颈病变的重要病因学因素,可能诱发宫颈癌,HPV检测是筛查宫颈癌的一种有效辅助方法;HPV感染率的年龄和地区性差异可能和受检者不同生活方式有关。Objective To evaluate the etiological significance of human papillomavirus (HPV)in cervical cancer and the clinical utility of HPV detection in cervical cancer screening. Methods Hybrid capture Ⅱ test was used to detect 13 high-risk HPV genotypes from cervical scrapes of 2636 women. Cervical cytology was also evaluated in 454 of them by ThinPrep Pap smear. Results Among 2636 women, 699 (26.5%) were found to be high-risk HPV positive. The highest infection rate(59.4%) was found in the age group of ≤ 20 years and the lowest infection rate in the age group of 41～50 years(21.0%). Significant differences in HPV infection rate were found between different cities in Guangdong province, such as those between Xinhui and Guangzhou, Xinhui and Shenzhen, Xinhui and Dongguan (P<0.01). Fifteen out of 16 women (93.8%)with cervical carcinoma were infected with high-risk HPV versus 24 out of 125 women (19.2%) attending routine cervical cancer screening ^(P<0.001) . The HPV infection rate was 30.8% (142 out of 461) in women with cervical erosion, which was significantly lower than that in patients with cervical carcinoma (P<0.001). HPV DNA were detected in 100% (2/2) of squamous cell carcinoma (SCC), 100% (12/12) high grade squamous intraepithelial lesion (HSIL), 88.9% (16/18) of low grade squamous intraepithelial lesion (LSIL) and 37.8% (28/74) of atypical squamous cells(ASC). Conclusion High-risk HPV genotypes are the major causes of cervical cancers and HPV detection is a reliable adjuvant tool for cervical cancer screening.

关 键 词：人乳头瘤病毒感染 宫颈肿瘤 病因学 对照研究 

分 类 号：R737.33[医药卫生—肿瘤]