第二代杂交捕获检测人乳头瘤病毒交叉反应对子宫颈筛查的影响  

Analysis of cross reactivity on human papillomavirus genotypes preformed by hybrid capture 2

作　　者：孙海魁[1] 陈汶[1] 陈凤[1] 刘新伏[1] 刘彬[1] 崔剑峰[1] 乔友林[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院肿瘤研究所流行病室,北京100021

出　　处：《中国肿瘤临床与康复》2013年第5期420-425,共6页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：美国克利夫兰医学基金资助(项目编号CMSI#09301)

摘　　要：目的研究第二代杂交捕获(hc2)检测人乳头瘤病毒(HPV)的交叉反应,分析其对子宫颈癌筛查的影响。方法 2006至2007年,中国山西襄垣、河南新密、新疆和田16～54岁的2625位妇女参加了子宫颈筛查,分别接受细胞学检查和高危型HPV hc2(hc2-H)检测。601例hc2-H阳性或细胞学诊断≥ASC-US的患者,接受电子阴道镜活检。再从筛查结果阴性者中,随机抽取10%(202例)。对这803例(包括202例阴性和601例阳性)患者采用低危型hc2试剂盒(hc2-L)检测,并且用LA(linear array)试剂盒对HPV分型。hc2对检测范围外的HPV型别的阳性结果被定义为交叉反应(CR),包括hc2-H交叉反应(HCR)和hc2-L交叉反应(LCR)。结果诊断结果为689例正常、82例轻度宫颈上皮内瘤变(CIN1)和32例宫颈上皮内瘤变2级以上病变(CIN2+)。经方差分析,组间的年龄差异无统计学意义(F=1.616,P=0.199)。hc2阳性率高于LA。仅针对hc2的18种型别,hc2与LA检测一致率是75.0%,Kappa值0.569。HCR和LCR在全体筛查人群中分别是8.9%和10.3%,正常者中是10.2%和10.9%,CIN1中是5.3%和0.0%。CIN2+组未发现交叉反应情况。多重感染者中交叉反应率不足2%。LCR以HPV55型较多见,HCR集中体现在HPV53、66和82上。结论使用全长RNA探针检测HPV DNA的第二代杂交捕获试验试剂主要进行筛查,其交叉反应发生在普通人群和CIN1患者,由于CIN2样本量小且主要感染为高危型,未发现交叉反应。Objective To study the cross reactivity of hybrid capture 2（hc2） assay with human papillomavirus（HPV） genotypes and its effect on cervical cancer screening.Methods From 2006 to 2007,cervical cells were collected from 2625 women aged 16 to 54 as part of cross-sectional,populationbased studies conducted in Shanxi,Henan,and Xinjiang provinces.601 women who screened positive by high-risk hc2（hc2-H） or had abnormal cytology results worse than atypical squamous cells of uncertain signi？ cance（ASC-US） underwent colposcopy with biopsy.From 2024 women who tested negative in both cytology and hc2-H,202（10%） were selected randomly to serve as negative controls.In total,803 women（601 with positive hc2 screening and 202 negative controls） underwent low-risk hc 2（hc2-L） assay and linear array（LA） genotyping.Cross-reactivity（CR） was defined as positive on untargeted HPV types by hc2 probes including hc2-L（LCR） and hc2-H（HCR）.Results Results showed 689 normal diagnosis,82 cases of CIN1,and 32 cases of CIN2 or worse（CIN2 ＋）.By variable analysis,the age difference between the three groups was not statistically significant（one way ANOVA,F = 1.616,P = 0.199）.The rate of positivity for hc2 was higher than LA.For the 18 HPV subtypes targeted by hc2,the concordance rate between hc2 and LA was 75.0% with Kappa value 0.569.The concordance rate between HCR and LCR were 8.9% and 10.3% in all biopsies,10.2% and 10.9% in normal,5.3% and 0.0% in CIN1.No CR was found in CIN2 ＋ cases.CR in women with multiple HPV subtype infections was less than 2%.LCR was commonly seen with HPV55 infection.HCR was commonly seen with HPV types 53,66,and 82.Conclusions The second-generation hybrid capture（hc2） uses full-length RNA probes to detect HPV DNA in cervical cancer. In our study,CR occurred in the normal population and CIN1 patients.CR was not seen in CIN2 ＋ cases due to the small sample size and high proportion of infection with high-risk HPV strains.

关 键 词：人乳头瘤病毒 二代杂交捕获 交叉反应 

分 类 号：R737.33[医药卫生—肿瘤]