高危型人类乳头瘤病毒检测对不典型鳞状细胞分流监测的临床价值  

Evaluation of high-risk HPV testing in triage of patients with atypical squamous cells of undetermined significance

作　　者：岑坚敏[1] 钱德英[1] 王丁[2] 曾仁海[3] 林爱华[4] 舒焰红[1] 洪淡华[1] 黄志宏[1] 

机构地区：[1]广东省人民医院妇产科,广州510080 [2]广东省人民医院妇产科 检验科,广州510080 [3]广东省人民医院妇产科 病理科,广州510080 [4]中山大学公共卫生学院医学统计流行学系教研室

出　　处：《中华妇幼临床医学杂志（电子版）》2006年第1期12-14,共3页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广东省科技计划项目(2002B30404)广东省医学科研基金(A2002024)

摘　　要：目的评价高危型人类乳头瘤病毒(HPV)检测对不典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)分流监测的临床价值。方法对654例宫颈细胞学检查结果为ASCUS的患者,进行高危型HPV检测和阴道镜检查,镜下定位活检可疑病灶,以病理学诊断作为金标准。结果 654例中,高危型HPV检测呈阳性的病例为411例,阳性率为62．8%。经病理学确诊宫颈上皮内瘤样病变(CIN)病例为58例,占总数的8．9%(58/654),其中CINⅡ和CINⅢ共计43例,占CIN的 74．1%(43／58);CINⅡ,CINⅢ的高危型HPV阳性率分别为80．8%及94．1%。ASCUS患者中以高危型 HPV检测、直接选择阴道镜检查,检出CIN的敏感度分别为88．9%和65．5%;对诊断CINⅡ和CINⅢ,高危型HPV的敏感度为94．1%,阴道镜的敏感度为65．1%。结论 ASCUS患者中高危型HPV的CINⅡ和 CINⅢ检出有较高的敏感度,对ASCUS可有效地进行分流监测,患者可不必再做阴道镜检查和活检。Objective To evaluate high-risk HPV testing in triage of women with atypical squamous cells of undetermined significance （ASCUS）. Methods High-risk HPV testing was performed reflexively on 654 liquid-based pap smears that had been interpreted as ASCUS. Final diagnosis was made by biopsy under the colposcopy. Results O0f the 654 women with cytological ASCUS, 411 （62.8%） were positive by high risk HPV testing. 58 cases wcre histologically confirmed as cervical intraepithelial neoplasia （CIN） （8. 9% ,58/654）. Of the 58 cases, 43（74.1%） were diagnosed as CIN Ⅱ and CINⅢ. By high-risk HPV testing, 80.8% of CIN Ⅱ and 94.1% of CIN Ⅲ were positive. The sensitivity to detect CIN was 88.9% with HPV triage, and 65.5% without HPV testing. The sensitivity to detect CIN Ⅱ and CIN Ⅲ was 94.1% by high risk HPV testing and 65. 1% by colposcopic examination. Conclusion HPV DNA testing of high risk types is a method of high sensitivity for identification of CIN Ⅱ and CIN Ⅲ in women with ASCUS. The application of HPV DNA testing will rest,It in a reduction of colposcopy and hiospy referrals.

关 键 词：高危型人类乳头瘤病毒榆测 不典型鳞状细胞 宫颈上皮内瘤样病变 阴道镜检查 诊断 

分 类 号：R450[医药卫生—治疗学]