新一代杂交捕获技术在宫颈癌筛查中的应用  

Application of a new generation of hybrid capture technology in cervical cancer screening

作　　者：余向红[1] 卢雁[1] 陈淑群[1] 邵志叶[1] 

机构地区：[1]慈溪市妇幼保健院,宁波315300

出　　处：《现代妇产科进展》2017年第5期342-344,348,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:了解新一代杂交捕获技术(DH2)在宫颈癌筛查与传统筛查方式的优势比较,探讨HPV16/18分型检测对DH2初筛阳性患者分流管理的临床意义。方法:2013年、2014年、2015年分别对浙江省慈溪市79847例、81702例、61072例妇女采用巴氏涂片的方法进行宫颈癌筛查,在2015年、2016年分别对浙江省慈溪市35657例、59634例妇女使用DH2检测14种高危型HPV的方法进行宫颈癌筛查。以病理诊断作为金标准,分析高危型HPV检测与巴氏涂片在LSIL以上病变的检出率情况。同时对DH2阳性患者进行HPV16/18检测,对照和比较HPV16/18分流策略的检出情况。结果:2013年、2014年、2015年采用巴氏涂片的方法对LSIL以上病变的检出率分别为0.048%、0.105%、0.134%;2015年、2016年使用DH2检测14种高危型HPV的方法对LSIL以上病变的检出率分别为0.415%、0.550%。2015年采用DH2检测14种高危型HPV初筛模式,LSIL以上病变在DH2阳性及在HPV16/18阳性中的占比分别为4.644%、15.370%;2016年采用DH2检测14种高危型HPV初筛及初筛阳性患者HPV16/18分流的模式,LSIL以上病变在DH2阳性及在HPV16/18阳性中的占比分别为6.365%、22.430%。结论:使用DH2检测14种高危型HPV的方法比传统巴氏涂片对LSIL以上病变的检出率更高,DH2可作为宫颈癌初筛的可行方法;DH2初筛及初筛阳性患者HPV16/18分流管理模式对宫颈癌高危人群进行风险分层管理,重点关注HPV16/18阳性人群,可以进一步提高宫颈癌筛查中的LSIL以上病变检出率。Objective：To compare the advantages of domestic HPV hybrid capture technology （DH2） in cervical cancer screening and traditional screening methods.To explore the clinical significance of HPV16/18 genotyping in the triage management of patients with DH2 positive screening.To provide a feasible and effective theoretical basis for the promotion and improvement of large-scale cervical cancer screening in rural areas.Methods：In 2013,2014 and 2015,79847,81702,and 61072 women were screened for cervical cancer by Pap smear separately.In 2015 and 2016,35657 and 59634 women screened for cervical cancer by 14 high-risk HPV detection respectively.The pathological diagnosis as the gold standard,analysis the rate of Low-grade Squamous Intraepithelial Lesion （LSIL） and above with high-risk HPV detection method and Pap smear.DH2 positive patients were detected by HPV16/18,and compared with the detection of HPV16/18 shunt strategy.Result：In 2013,2014 and 2015,the detection rates of LSIL and above were 0.048%,0.105% and 0.134% with Pap smear,respectively.In 2015 and 2016,the detection rates of LSIL and above were 0.415% and 0.550% with high-risk HPV detection,respectively.In 2015,DH2 as primary screening,the positive rates of LSIL and above in DH2 positive and HPV16/18 positive were 4.644% and 15.370%,respectively.In 2016,DH2 positive patients with HPV16/18 detection as primary screening,the positive rates of LSIL and above in DH2 positive and HPV16/18 positive were 6.365% and 22.430%,respectively.Conclusions：Compared with the traditional detection methods,the detection rate of cervical precancerous lesions by DH2 detection is higher.DH2 positive patients with HPV16/18 detection as primary screening can further improve the detection rate of LSIL and above disease in cervical cancer screening.

关 键 词：HPV 宫颈癌 检出率 筛查 分流 

分 类 号：R711[医药卫生—妇产科学]