人乳头瘤状病毒检测在宫颈上皮内瘤变及宫颈癌术后随访中的研究  

HPV detection during the follow-up after the cervical intraepithelial neoplasia and cervical cancer operation

作　　者：马学玲[1] 李红雨[1] 马双玲[1] 高玉霞[1] 姚俊阁[1] 

机构地区：[1]郑州大学第三附属医院妇产科,450052

出　　处：《中国实用医刊》2013年第6期6-8,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨宫颈上皮内瘤变（CIN）、宫颈癌术后高危型人乳头瘤状病毒（HR—HPV）清除规律并评价其检测在随访中的I临床价值。方法选取2010年6月至2011年6月郑州大学第三附属医院收治的CIN及宫颈癌患者152例，随访术后HR—HPV清除情况并分析其相关影响因素，进一步评价HPV检测预测术后出现阴道上皮不典型增生（VAIN）的临床价值。结果入选本研究的妇女共152例，年龄24～71岁，平均41．46岁；随访结束后128例患者（84．21％，128／152）HPV转阴，总体清除时间中位数为6．0个月。不同年龄组（〈35、35—45、46～55、〉55岁）妇女HPV清除时间中位数分别为3、5、8、11个月，组间比较差异有统计学意义（P〈0．01）；不同级别CIN（1～3级、CIN3级累腺、宫颈癌1、2期）清除时间中位数分别为3、6、8、6个月，组间比较差异有统计学意义（P=0．036）。术后发现阴道断端上皮内瘤变（VAIN）4例，HPV检测预测VAIN的灵敏度为100％，特异度为93．28％，阳性预测值为30．77％，阴性预测值为100％。结论HPV检测在宫颈疾病治疗后随访中有着重要的I临床价值。Objective To investigate the clearance of high-risk type human papillomavirus （ HR- HPV） after the cervical intraepithelial neoplasia and cervical cancer operation, and evaluate the clinical value of HPV test. Methods One hundred and fifty-two women taking along HR-HPV were enrolled in the study from June 2010 to June 2011. The time of HPV infection clearance and influence factors were analyzed. Further discussion of the significance of HPV test after the operation was given. Results One hundred and twenty-eight cases（84.21% , 128/152）cleared during the follow-up. The medium clearance time was 6.0 months. The medium clearance time of aged 〈 35, 35 -45, 46 - 55, 〉 55 were 3, 5, 8 and 11 months respectively. There were significant difference among aged intervals（ P 〈 O. 01 ）. The medium clearance time of groups cervical intraepithelial neoplasia, carcinoma in situ, cervical cancer 1 and 2 were 3, 6, 8, 6 months respectively. There were significant difference among groups interval （P -- 0. 036）. Four cases as vaginal intraepithelial neoplasia （VAIN） were detected after the operation. The sensitivity, specificity, positive predictive value and negative predictive value of HPV test were 100% , 93.28% , 30. 77% , 100%. Conclusions There has an important clinical value for HR-HPV DNA test after the operation of cervical disease.

关 键 词：宫颈癌 人乳头瘤状病毒 清除 临床价值 

分 类 号：R737[医药卫生—肿瘤]