高危型人乳头瘤病毒检测在高度宫颈上皮内瘤变治疗中的临床意义  

作　　者：张立杰 杨琳 刘妹 

机构地区：[1]深圳市人民医院暨南大学附属二院妇科,518020

出　　处：《当代医学》2010年第13期8-9,共2页Contemporary Medicine

摘　　要：目的探讨高危型人乳头瘤病毒(HPVDNA)在高度宫颈癌前病变(Cervical High-grade squamous intraepithe liallesion,HSIL)治疗中的临床应用价值。方法选择2006年3月～2009年4月间在深圳市人民医院门诊经过高危型HPVDNA,液基细胞学(Liquid-based cytology,LCT),阴道镜下定位活检,病理学结果为确诊≥CIN2,接受宫颈锥切术(The loop electrosurgical excision procedure,Leep)或冷刀锥切术(cold-knife conization,CKC)的186例患者资料。对术前术后随访中高危型HPV DNA变化与病变残留复发情况进行动态观察及分析。结果术前高度宫颈癌前病变高危型HPV DNA的阳性率95%;术后高危型HPV DNA转阴率为91%;手术切缘阳性或复发患者的高危型HPV DNA感染率明显高于手术切缘阴性患者的感染率;术后高危型HPV DNA阳性患者复发率高。结论高危型HPV DNA具有较高阴性预测值,术后高危型HPV DNA转阴的患者愈后良,手术可大大提高的高危型HPV DNA的转阴率。Objective To study the clinical value of high-risk human papillomavirus（HPV）treated in cervical precancerous lesions（HSIL）. Methods Choose from March 2006 to April 2009 in Shenzhen People’s Hospital in out-patient after high-risk HPV DNA, liquid-based cytology （Liquid-based cytology, LCT）, colposcopy biopsy, pathology results confirmed≥CIN2, accepted the loop electrosurgical excision procedure（Leep） or cold knife conization （cold-knife conization, CKC） of the 186 cases of patients.Observed and analysed the high-risk HPV DNA change and disease recurrence remains the dynamic which were followed-up preoperative and postoperative. Results The positive rate of high degree of cervical precancerous lesions of preoperative high-risk HPV DNA was 95%, After high-risk HPV DNA negative conversion rate was 91%; positive surgical margins or recurrence in patients with high-risk HPV DNA prevalence was signif icantly higher than in patients with negative surgical margin rate of infection; after high-risk HPV DNA-positive patients with high recurrence rate. Conclusion High-risk HPV DNA has a high negative predictive value, and after high-risk HPV DNA negative conversion in patients with good prognosis, surgery can greatly improve the high-risk types of HPV DNA negative rate.

关 键 词：宫颈上皮内瘤变(Cervical intraepithelial neoplasia CIN) 高危型HPV DNA 宫颈电环切除术(LEEP) 

分 类 号：R737.33[医药卫生—肿瘤]