微量元素预测新疆巴楚县维吾尔族妇女HPV感染、宫颈高级别病变及宫颈癌的价值分析  

Relationship between human papilloavirus infection,high-grade cervical lesions including cervical cancer and behavior factors,trace elements for Uyghur women in Bachu County,Xinjiang

作　　者：路玲[1] 刘琴[1] 古扎丽努尔.阿不力孜 董志红[2] LU Ling LIU Qin Guzalnur Abliz DONG ZhiHong(Department of Gynecology V Hysteroscopy Room, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China)

机构地区：[1]新疆医科大学附属肿瘤医院妇外五科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院宫腔镜室,乌鲁木齐830011

出　　处：《新疆医科大学学报》2017年第1期11-16,共6页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81272335)

摘　　要：目的探讨血清微量元素水平预测新疆巴楚县维吾尔族妇女HPV感染、宫颈高级别病变及宫颈癌的价值,为微量元素在预防控制和治疗宫颈疾病方面提供依据。方法 2014年3月1日-6月15日在新疆巴楚县选择细胞学ASC-US及以上、care HPV检测阳性或VIA/VILI阳性者646例及2011年3月1日-2014年6月15日在新疆医科大学附属肿瘤医院妇科住院确诊的来自巴楚县的宫颈疾病患者187例进入研究队列。检出宫颈高级别病变(≥CIN2)及宫颈癌者作为病例组,慢性宫颈炎及CINⅠ级者作为对照组;HPV感染者作为阳性组,未感染者作为阴性组。采用原子荧光光谱法、电子耦合-等离子体原子发射光谱仪测定血清中铁(Fe)、砷(As)、镍(Ni)、硒(Se)微量元素含量,采用诊断试验评价与接收者工作特征曲线来分析血清微量元素对HPV感染、宫颈高级别病变及宫颈癌的预测价值。结果 As、Ni、Se预测HPV感染的诊断价值均较低,ROC曲线下面积<0.7;单用Se、Se和As联合、Se和Ni联合用于预测宫颈高级别病变及宫颈癌的诊断价值中等,ROC曲线下面积>0.7,其灵敏度和阴性预测价值较高,假阴性率较低,但特异度、正确率和阳性预测价值较低,假阳性率较高。结论血清Se、Se和As联合、Se和Ni联合可用于新疆巴楚县维吾尔族妇女宫颈高级别病变及宫颈癌的初步筛检。Objective To study the diagnostic value of trace elements applied in predicting HPV infection and high cervical lesions in order to provide useful information for intervention of cervica Lesions.Methods 646 objects with≥ASC-US or care HPV positive or VIA/VILI positive were enrolled through screening 5045 Uyghur women in Bachu of Xinjiang from March 1,2014 to June 15,2014.In addition,187 objects with cervical disease from Bachu were enrolled in the department of gynecology in the Affiliated Tumor Hospital of Xinjiang Medical University.All participants underwent biopsy under colposcope for his-topathologic examination.The participants with ≥CIN2 were regarded as case group,and 〈CIN2 as con-trol group.The participants with HPV infection were regarded as HPV positive group,and without HPV infection as HPV negative group.All participants underwent epidemiological investigation,and the concen-trations of trace elements in serum were detected.diagnostic value of trace elements in predicting HPV in-fection and high cervical lesions including cervical cancer were analyzed with diagnostic test and receiver operating characteristic （ROC）curve.Results The diagnostic value of As,Ni,Se applied in predicting HPV infection were low,and the area under ROC curve was lower than 0.700;Se,Se combined with As, and Se combined with Ni maybe could be applied in predicting high cervical lesions including cervical canc-er,and their area under ROC curve was higher than 0.700.The sensitivity and negative predictive value were high,and false negative rate was lower;but the specificity,accuracy and positive predictive value were lower,and false positive rate was high.Conclusion Se,Se combined with As,and Se combined with Ni may be applied in the preliminary screening of high cervical lesions including cervical cancer.

关 键 词：宫颈病变 微量元素 诊断价值 维吾尔族 

分 类 号：R737.33[医药卫生—肿瘤]