髙危型HPV检测在宫颈病变诊断中的价值  

Value of high-risk HPV DNA testing in diagnosis of cervical lesions

作　　者：李明霞[1,2] 戴淑真[1] 刘丽芝[1] 车艳辞[1] 初慧君[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003 [2]青岛大学医学院

出　　处：《山东医药》2009年第6期4-6,共3页Shandong Medical Journal

摘　　要：目的探讨高危型HPV检测在宫颈病变诊断中的价值。方法720例宫颈病变患者先进行HPVDNA的杂交捕获法二代(HPV-HCⅡ)和液基细胞学(TCT)的检测,其中224例因细胞学异常(意义未明的非典型鳞状细胞以及以上的病变)行阴道镜下活检。结果720例患者HPV阳性者264例(36.7%),阴性者456例(63.3%)。HPV阳性组患者年龄(37.77±8.48)岁,HPV阴性组年龄(39.25±8.83)岁,两组比较P<0.05。224例细胞学异常患者HPV感染率分别为炎症和复鳞上皮乳头瘤样增生64.9%(61/94)、宫颈上皮内瘤变(CIN)Ⅰ82.8%(24/29)、CINⅡ89.7%(26/29)、CINⅢ93.5%(58/62)、浸润癌100%(10/10),随病理级别的升高HPV感染率显著升高(P<0.05)。57例细胞学检测为ASC-US的患者中宫颈高度病变(≥CINⅡ)检出率为24.6%(14/57),HPV阳性组检出率为33.3%(12/36),阴性组为9.5%(2/21),两组比较,P<0.05,阴性组无浸润癌和CINIII的检出。87例细胞学为LSIL的患者中宫颈高度病变检出率为34.5%(30/87),HPV阳性组检出率为39.5%(30/76),阴性组为0,两组比较P<0.01,阴性组无高度病变的检出。结论高危型HPV检测可以明显提高宫颈高度病变在细胞学为ASC-US及LSIL中的检出率。Objective To investigate the significance of high-risk human papillomavirus （HR - HPV） DNA testing in diagnosis of cervical lesions. Methods A total of 720 cases had been detected by liquid-based cytology test and HR-HPV DNA testing with hybrid capture Ⅱ , in which 224 cases received cervical biopsy because of abnormal cytology （ ≥ ASCUS）. Results The overall prevalence of HPV infection was 36.7%. The age of 246 patients who were HPV positive was 37.77 ± 8.48, while 456 patients HPV negative was 39.25 ± 8.83, P 〈 0. 05. In the 224 cases （ ≥ASC-US） , the rates of HPV infection were 64.9% （61/94）in chronic cervicitis and tratified squamous epithelia papillomatous hyperplasia, 82. 8% （24/29） in CIN Ⅰ , 89.7% （ 26/29 ） in CIN Ⅱ ,93.5 % （ 58/62 ） in CIN Ⅲ and 100% （10/10） in invasive cervical cancer. The rate was increased with aggravation of cervical histology changes （ P 〈 0.05 ） . In 57 patients with abnormal cervical eytology of ASC-US ,the rate of high-grade cervical lesions was 24.6%, and it was higher in HPV positive group（33.3% ） than in HPV negative group （9.5 % ） , P 〈 0.05. Thero were no CIN Ⅲ and invasive cervical cancer in HPV negative group In 87 patients with abnormal cervical cytology of LSIL,the rate of high-grade cervical lesions was 34.5% , which was even higher in HPV positive group （39.5%）than in HPV negative group （0） ,P 〈 0.01. Conclusion High-risk HPV DNA testing can improve detection rate of high-grade cervical lesions in patients with cytology of ASC-US and LSIL and prevent misdiagnosis and improper therapy.

关 键 词：人乳头状瘤病毒 宫颈病变 

分 类 号：R711.74[医药卫生—妇产科学]