DNA异倍体定量检测用于高危型HPV感染妇女分流诊治的临床价值  

Study on the clinical significance of quantitative detection of DNA heteroploid in diagnosis and treatment of high-risk type HPV infected women

作　　者：徐灵[1,2] 徐军 陶敏芳[1] 

机构地区：[1]上海交通大学附属第六人民医院妇产科,上海200233 [2]上海市闵行区中心医院妇产科,上海201199

出　　处：《临床和实验医学杂志》2016年第8期783-786,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市闵行区卫生局科研课题项目(编号:2013MW20)

摘　　要：目的针对DNA异倍体定量检测用于高危型人乳头瘤病毒（HPV）感染妇女分流诊治的临床价值进行研究。方法随机选择2012年11月至2013年6月进行DNA异倍体定量检测的患者600例,作为本次研究的对象,对患者实施DNA异倍体定量检查,检查结果为高危型HPV阳性的患者实施阴道镜检查,确诊后实施分流诊治。针对宫颈病变检出情况、DNA异倍体异常细胞数等指标进行分析研究。结果 600例患者DNA异倍体定量检测中,47例宫颈高级别鳞状上皮病变（CIN Ⅱ-Ⅲ）及宫颈癌,65例宫颈低级别鳞状上皮病变,77例高危型HPV阳性。DNA倍体异常细胞个数分析中,宫颈高级别鳞状上皮病变（CIN Ⅱ-Ⅲ）及宫颈癌患者中89.36%DNA倍体异常细胞≥3个,宫颈低级别鳞状上皮病变患者中78.46%DNA倍体异常细胞≥3个,或者可见少量DNA倍体异常细胞（1-2个）。高危型HPV阳性患者中45.45%DNA倍体异常细胞≥3个,29.87%可见少量DNA倍体异常细胞（1-2个）。液基细胞学检查和阴道镜检查,对DNA异倍体检查异常细胞患者进行诊断,确定患者的疾病为高危型HPV阳性患者中,19例患者DNA异倍体定量检测结果为未见DNA倍体异常细胞,阴道镜检查报告为宫颈炎。35例DNA异倍体定量检测结果为可见DNA倍体异常细胞患者中,48.57%阴道镜检查结果为高级别鳞状上皮病变,28.57%的阴道镜检查为低级别鳞状上皮病变,22.86%阴道镜检查结果为宫颈炎。可见少量DNA倍体异常细胞患者中,8.70%阴道镜病理结果为高级别鳞状上皮病变,30.43%为低级别鳞状上皮病变,60.87%为宫颈炎症。结论实施DNA异倍体检查,有较高的病变检出率,DNA异倍体检查结果为正常的患者大多为宫颈炎,检测出异常的患者需进一步的确诊。DNA异倍体检查,为患者高危型HPV感染的早期预防提供有效的诊断依据,有较高的临床应用价值。Objective To explore the significance of quantitative detection of DNA heteroploid in diagnosis and treatment of women with high-risk type HPV infection. Methods A total of 600 cases with quantitative detection of DNA heteroploid in this hospital during November2012 to June 2013 were randomly selected for this study,then patients with positive result of examination for high-risk type HPV infection were further examined with colposcopy,and they received treatment after confirmation of the diagnosis. In order to solve the problem for detection of cervical lesions,indices such as the amount of abnormal cells with DNA heterploid etc had been studied. Results Among 600 patients with quantitative detection of DNA heteroploid in this study,47 patients had cervical squamous epithelial lesions in high level（ CIN II-III） and cervical cancer,65 patients with cervical squamous epithelial lesions in low level,and 77 patients with high risk type HPV infection. The analysis of number of abnormal cells with DNA heteroploid showed that in patients with high level cervical squamous epithelial lesions（ CIN II-III） and 89.36% patients with cervical cance had abnormal cells with DNA heteroploid over or equal to three,and 78. 46% patients with low level of cervical squamous epithelial lesions,abnormal cells with DNA heterploid were three or more,or a small amount of abnormal cells with DNA heteerplod（ 1- 2）. In high risk HPV positive patients,45. 45% abnormal cells with DNA heterploid were ≥ three or more,29. 87% with small amount of DNA heterploid abnormal cells（ 1 - 2）. The application of liquid based cytology and colposcopy examination in diagnosis of patients with DNA heterploid abnormal cells,in patients with high-risk type HPV,the results of DNA heteroploid quantitative test in 19 cases showed that no abnormal cells had been seen,and their colposcopic examination diagnosed as cervicitis. The results of quantitative detection of DNA heterploid in 35 patients with abnormal cells,results of colposcopic examination

关 键 词：高危型HPV感染 DNA异倍体定量检测 分流诊治 

分 类 号：R737.33[医药卫生—肿瘤]