高危型 HPV 基因型检测在新疆宫颈癌筛查中的临床应用价值  

Clinical value of high-risk HPV genotyping in cervical cancer screening in Xinjiang

作　　者：马春华[1,2] 吐尔逊阿衣·买买提明[2] 王琳[2] 朱开春[2] 玛依努尔·尼牙孜[2] 

机构地区：[1]新疆医科大学研究生院,新疆乌鲁木齐830054 [2]新疆维吾尔自治区人民医院妇科

出　　处：《中国生育健康杂志》2016年第5期432-437,共6页Chinese Journal of Reproductive Health

基　　金：国家自然科学基金资助项目（81150317）

摘　　要：目的：评价高危型 HPV 基因型检测在宫颈癌筛查中的可行性及应用价值。方法2014年9月—2015年8月于新疆地区行宫颈癌筛查女性564例，应用第二代反向点杂交捕获法（HC2）和液基薄层细胞检测技术（TCT）进行 HPV 基因型定性检测及细胞分类学诊断，对活检标本进行病理定性诊断后，采用实时荧光定量PCR 方法（COBAS HPV）对剩余宫颈剩余脱落细胞进行高危型 HPV（HR-HPV）基因型检测。结果高危型 HPV基因型检测在诊断 CIN2＋病变时优于 HC2、TCT 检测，不同液基细胞学分级及组织病理分级中 HR-HPV 感染率不同，随细胞学及病理学诊断级别升高，HR-HPV 感染率上升，HPV-16型感染率上升。各级别宫颈病变以 HPV-16及合并 HPV-16型感染为主，HPV-16型在维吾尔族和汉族妇女分布无差异。高危型 HPV 基因型检测对 ASCUS 分流优于 HC2。结论高危型 HPV 感染是宫颈癌前病变和宫颈癌的主要致病因素；宫颈各级别病变中以 HPV-16型及合并 HPV-16型感染为主；随细胞学及病理学诊断级别升高，HR-HPV 感染率上升；HR-HPV 基因型检测优于HC2、TCT 检测，在新疆地区宫颈癌筛查中具有较高的临床应用价值。Objective To evaluate the feasibility and application of high-risk HPV genotyping in cervical cancer screening. Methods High-risk genotyping was carried out for cervical cell samples in 564 female patients who were underwent cervical cancer screening as well as HC2 and TCT test with pathological results in Xinjiang Uygur Autonomous Region between September 2014 and August 2015. Results For the diagnosis of CIN2 ＋,high-risk HPV genotyping was better than HC2 and TCT.The difference was statistically significant （P 〈0.05）.HR-HPV infection rate varied by TCT classification and tissue pathology grading （P 〈0.05）.With increase in the grade of cytology and pathological diagnosis, HR-HPV infection rate （P 〈0.05）and HPV16 infection rate （P 〈0.05）were increased.All levels of cervical lesions were mainly seen in HPV16 or multiple infections including HPV16.The distribution of HPV16 in Uyghur and Han women was not statistically different （P 〉0.05）.High-risk HPV genotyping to ASCUS bypass was superior to HC2. Conclusion High-risk HPV infection was a main pathogenic factor for precancerous change and cervical cancer.All levels of cervical lesions were associated with HPV16 or multiple infections including HPV16.HR-HPV infection rate increased with cytological and pathological diagnosis grade.High-risk HPV genotyping has clinical value in the screening of cervical cancer in Xinjiang region,and this technique is superior to HC2 and TCT.

关 键 词：人乳头状瘤病毒 宫颈癌 高危型 HPV 基因型检测 

分 类 号：R737.330.2[医药卫生—肿瘤]