高危型人乳头状瘤病毒检测用于宫颈病变筛查的评价  

Evaluation of High Risk Human Papillomavirus Detecting Using in Screening of Cervical Lesion

作　　者：刘洁[1] 平静[2] 王俊利[3] 常正义[3] 庞广福[3] 黄海玲[1] 

机构地区：[1]右江民族医学院组织胚胎学教研室,广西百色533000 [2]右江民族医学院附属医院病理科,广西百色533000 [3]右江民族医学院附属医院检验科,广西百色533000

出　　处：《苏州大学学报（医学版）》2011年第1期115-117,126,共4页Suzhou University Journal of Medical Science

基　　金：广西科学研究与技术开发项目资助(桂科攻0993003D-19);广西壮族自治区卫生厅科研项目资助(Z2010083);右江民族医学院科研项目资助(右科0702)

摘　　要：目的探讨高危型人乳头状瘤病毒(HR-HPV)检测在宫颈病变筛查中的价值。方法分析380例同时行HR-HPV检测、液基细胞学检查和活组织病理学检查的宫颈病变筛查患者的临床资料。结果以活检宫颈上皮内瘤样变Ⅰ级(CINI)及CINI以上判定为活检阳性,活检阳性组HR-HPV感染率(85.4%)与阴性组(39.1%)相比,差异有高度统计学意义(P<0.01),CINⅠ、CINⅡ、CINⅢ和宫颈癌组HR-HPV感染率分别为77.5%、85.3%、91.9%和100%。细胞学检查为宫颈上皮内病变阴性(NILM)病例中,HR-HPV阳性组活检阳性率(47.4%)与阴性组(28.1%)相比;意义不明确的不典型鳞状细胞(ASCUS)病例中,HR-HPV阳性组活检(阳性率65.1%)与阴性组(23.4%相比;低度和高度鳞状上皮内病变(LSIL,HSIL)病例中,HR-HPV阳性组活检阳性率(88.6%)与阴性组(15.8%)相比;以上各组差异均有统计学意义(P<0.05或P<0.01)。结论 HR-HPV感染率与宫颈病变严重程度呈正相关,HR-HPV检测在宫颈病变筛查中有很重要的临床价值。Objective To evaluate the value of high risk human papillomavirus （HR-HPV） detec- tion in screening of cerical lesions. Methods HR-HPV detection, thinprep cytology test and biopsy were all performed to detect in 380 patients. Results Patients with cervical intraepithelial neoplasias I （CIN I ） grade and more than CIN I grade were regarded as biopsy-positive cases. The infection rate of HR-HPV was 77.5% in CIN I , 85.3% in CINII , 91.9% in CIN III and 100% in squamous cell carcinoma. The infection rate of HR-HPV in biopsy-positive group was 85.4% , while which in biopsy-negative group was 39.1% , the discrepancy was highly statistically significant（ P 〈 0.01 ） . The positive rate of biopsy in HR-HPV-positive group in which intraepithelial lesion or malignancy was negative （NILM） was 47.4% , while that in HR-HPV-negative group was 28.1%. The positive rate of biopsy in HR-HPV-positive group in which atypical squamous cells of undetermined significance （ASCUS） were avaibable was 65.1% , while that in HR-HPV-negative group was 23.4% , The positivity rate of biopsy in HR-HPV- positive group with low and high grade squamous intraepithelial lesion （ LSIL, HSIL） was 88.6% , while that in HR-HPV-negative group was 15.8%, the discrepancy were all statistically significant（P 〈 0.05 or P 〈0.01 ）. Conclusion The infection rate of HR-HPV and severity of cervical lesions is positively correlated. HR-HPV detection has important clinical value in screening of cervical lesions.

关 键 词：人乳头瘤状病毒 宫颈病变 活组织检查 细胞学 

分 类 号：R373[医药卫生—病原生物学]