高危型人乳头瘤病毒DNA检测在宫颈高度鳞状上皮内病变治疗后随访中的价值  

The value of high-risk HPV-DNA testing during the follow-up for women with high-grade squamous intraepithelial lesions

作　　者：陈观娣[1] 钱德英[1] 李志刚[1] 岑坚敏[1] 欧阳云雁[1] 

机构地区：[1]广东省医学科学院广东省人民医院妇产科,广东广州510080

出　　处：《中国实用妇科与产科杂志》2010年第9期708-710,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省科技计划项目基金(2002B30404)

摘　　要：目的探讨高危型人乳头瘤病毒(HPV)DNA检测在宫颈高度鳞状上皮内病变治疗后随访中的作用。方法对2003年1月至2007年12月在广东省人民医院因宫颈癌前病变行宫颈电环切除术的502例妇女的随访资料进行回顾性分析。结果组织病理学证实28例存在病变残留或复发,高危型HPV-DNA检测诊断病变残留或复发的敏感性、特异性、阳性预测值、阴性预测值分别为92.86%,84.18%,25.74%,99.50%。术前HPV负荷量与病变复发或残留之间不存在相关性(P=0.7163)。术后HPV负荷量与病变残留或复发之间存在等级相关(P=0.010)。结论高危型HPV-DNA检测诊断宫颈癌前病变治疗后残留或复发的敏感性及阴性预测值高。术前HPV负荷量与术后病变残留或复发无相关性。术后HPV负荷量越高,术后病变残留或复发率越高。Objective To evaluate high-risk HPV-DNA testing during the follow-up for women after LEEP with high-grade squamous intraepithelial lesions （ HSIL）. Methods A retrospective study was conducted on 502 women who underwent LEEP for HSIL in Guangdong General Hospital between January 2003 and December 2007. Results 28 women were confirmed residual/recurrent by histology reports. The sensitivity, specificity, positive predictive value, negative predictive value of high risk HPV-DNA test for diagnosis of residual/recurrent was 92. 86% , 84. 18% , 25.74% and 99. 50%. There was no correlationship between pre-LEEP HPV viral load and residual/recurrent lesions （P = 0. 7163 ）. Post-LEEP HPV viral load have a positive correlation with residual/recurrent lesions （ P = 0. 010）. Conclusion High risk HPVDNA testing is a simple and objective method with high sensitivity and negative predictive value for post-LEEP women during follow-up for them. There was no correlationship between pre-LEEP HPV viral load and residual/recurrent. Residual/recurrent was more likely to occur when the post-LEEP HPV virus load was high.

关 键 词：人乳头瘤病毒 残留 复发 宫颈高度鳞状上皮内病变 

分 类 号：R71[医药卫生—妇产科学]