细胞图像DNA倍体分析结合高危型HPV、支原体和衣原体检查与宫颈上皮内瘤变相关性研究  

The Study on relationship between cervical dysplasia and microbial infections with cervical epithelial DNA-Ploidy analysis

作　　者：张立冬[1] 张慧敏[1] 刘美玲[1] 江庆萍[1] 聂琨 

机构地区：[1]广州医科大学附属第三医院妇产科,广东510150 [2]厦门麦克奥迪医学检验所

出　　处：《中华实验和临床病毒学杂志》2014年第6期433-436,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：广东省科技计划（项目编号2006835930002）

摘　　要：目的 探讨宫颈细胞DNA倍体、高危型HPV、支原体和衣原体检测结果与宫颈上皮内瘤变的相关性,以期结合宫颈感染情况,预测宫颈筛查结果阳性妇女真正罹患宫颈癌前病变的风险,避免宫颈过度治疗.方法 将参加筛查的285名育龄妇女分别采用宫颈细胞图像DNA倍体分析（DNA-ICM）、高危型HPV检查（PCR法）、支原体（UU/Mh）以及衣原体（CT）检查.以阴道镜下宫颈活检的病理学诊断为金标准,分别计算了各种检查方式,对宫颈病变诊断的敏感性、特异性、预测值等.结果 在285个病例的活检结果中,共有慢性炎症179例,CIN Ⅰ级60例,CIN Ⅱ级20例,CINⅢ级25例;癌1例.Logistic回归分析显示,细胞DNA倍体异常与宫颈癌及癌前病变相关性最为显著,其次为高危型HPV感染.UU/Mh和CT感染均无明显相关性.所有存在微生物感染患者中,CINⅠ罹患者中32.43％为双因素感染,而CIN Ⅲ患者为56％.而在CIN Ⅱ中单独出现HR HPV感染的占50.00％,而CIN Ⅲ中占40％.结论 宫颈细胞DNA倍体阳性合并高危型HPV感染者应高度警惕为癌变高危人群,若同时出现UU/Mh感染,将有助于提高诊断的准确性.Objective To explore the relationship between cervical dysplasia and high risk type of Human Papillomavirus （HR-HPV）,Ureaplasma urealyticum/ Mycoplasma hominis （UU/Mh） or Chlamydia Trachomatis （CT） infections with cervical epithelial DNA Ploidy Analysis,so that combining the infection with the result of cervical cancer screening test to evaluate the real risk of cancer or precancerosis to avoid over-diagnosis and over-treatment.Methods Cervical samples from 265 women on child-bearing age were involved in cervical cancer screening with DNA-Ploidy Analysis （DNA-ICM）.The women＆#39; s samples also be tested by HPV test,UU/Mh test and CT test.The biopsy result is regarded to be the golden standard.Results Among the 285 biopsy results,the chronic cervicitis occupied 179,CIN I 60,CIN Ⅱ 20 CIN Ⅲ 25 and cervical cancer 1.Regression result indicated that DNA-Aneuploid and HR HPV have highest risk to cervical lesion.In the group with infectious factors,the ones with dual-factor infection in CIN Ⅰ is 32.43% while 56.00% in CIN Ⅲ as the most.Nevertheless,the most in CIN Ⅱ is HR-HPV as 50.00%,which emerged as 40.00% in CIN Ⅲ.Conclusion The group with DNA aneuploidy combined with HR-HPV infection or HR-HPV and UU/Mh infection has the high potential risk of malignancy.

关 键 词：乳头状瘤病毒 人 支原体属 衣原体 病理学 

分 类 号：R737.33[医药卫生—肿瘤]