高危型人乳头瘤病毒检测在宫颈病变筛查及诊断中的意义  

Significance of the high-risk human papilloma virus detection in the screening and diagnosis of cervical lesions

作　　者：高娜[1] 郑军[1] 石红[1] 吴涛[2] 

机构地区：[1]大连医科大学附属第一医院妇产科,116011 [2]大连医科大学附属第二医院肿瘤科,116027

出　　处：《中国医师进修杂志》2012年第21期7-10,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨高危型人乳头瘤病毒（HPV）检测在宫颈病变筛查及诊断中的意义。方法收集797例宫颈病变患者的高危型HPV DNA检测结果，全部患者同时具有细胞学及组织病理学检测结果，进行回顾性分析。结果宫颈炎、宫颈上皮内瘤变（CIN）Ⅰ、CINⅡ、CINⅢ及宫颈癌高危型HPV DNA阳性率分别为53．41％（188／352）、70．91％（117／165）、87．63％（85／97）、97．90％（140／143）、97．50％（39／40）；高危型HPV DNA检测对CINⅡ及以上病变的敏感度和阴性预测值分别为96．66％（318／329）、93．29％（153／164）；高危型HPV DNA阳性的意义不明的非典型鳞状细胞（ASCUS）患者CINⅡ及以上病变检出率为30．03％（94／313），阴性者为1．55％（2/129）。结论高危型HPV DNA阳性率随着宫颈病变程度的加重呈递增趋势，与CINⅢ和宫颈癌的关系最密切；高危型HPV DNA检测对CINⅡ及以上病变具有很高敏感度和阴性预测值；高危型HPV DNA检测对ASCUS中的CINⅡ及以上病变具有很高的阴性预测值。Objective To investigate the significance of the high-risk human papilloma virus （HPV） detection in the screening and diagnosis of cervical lesions. Methods The high-risk HPV DNA test results of 797 patients with cervical lesions who all accepted cytology and histopathology test were collected and analyzed retrospectively. Results The high-risk HPV DNA positive rates in cervicitis,cervical intraepithelial neoplasia （CIN） Ⅰ ,CIN Ⅱ ,CIN Ⅲ and cervical cancer were 53.41% （188/352）,70.91% （117/165）,87.63%（85/97）,97.90%（140/143）, 97.50%（39/40）,respectively. The sensitivity and negative predictive value of the high-risk HPV DNA detection for CIN Ⅱ and more serious lesions were 96.66% （318/329）, 93.29%（153/164）, respectively. The detection rate of CIN Ⅱ and more serious lesions in patients with atypical squamous cells of undetermined significance （ASCUS） and positive high-risk HPV DNA was 30.03% （94/313）,while the rate in patients with negative high-risk HPV DNA was 1.55% （2/129）. Conclusions The more serious the cervical lesion is, the higher high-risk HPV DNA positive rate is. It is most closely related with CIN Ⅲ and cervical cancer. The high-risk HPV DNA detection has high sensitivity and negative predictive value for CIN Ⅱ and more serious lesions. The high-risk HPV DNA detection has high negative predictive value in CIN Ⅱ and more serious lesions in ASCUS.

关 键 词：宫颈疾病 人乳头瘤病毒 宫颈筛查 

分 类 号：R737[医药卫生—肿瘤]