尖锐湿疣早期诊断方法  

Early diagnostic methods for condyloma acuminatum

作　　者：张武[1] 罗丽芳[1] 黄清华[1] 罗妙旋 何伟[1] ZHANG Wu;LUO Lifang;HUANG Qinghua;LUO Miaoxuan;HE Wei(Department of Dermatology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 511447,China)

机构地区：[1]广州医科大学附属第二医院皮肤科,广东广州511447

出　　处：《包头医学院学报》2018年第5期1-3,共3页Journal of Baotou Medical College

基　　金：广州市医药卫生科技项目(项目编号:20161A010099);广州市中医药科技项目(项目编号:20162A011023)

摘　　要：目的:探讨免疫荧光技术检测潜伏感染期人乳头瘤病毒的敏感性和特异性,为早期诊断尖锐湿疣提供新思路。方法:81例尖锐湿疣患者进行CO2激光切除疣体,切除的疣体做病理检查;同时取部分疣体,用PCR-反向点杂交法检测HPV亚型;3周后复诊,取脱落细胞行免疫荧光检查,随访6个月,观察患者的复发情况,对照组患者50例,均为泌尿外科手术切除的正常包皮。结果:PCR-反向点杂交法检测结果显示尖锐湿疣组均为阳性,其中HPV-6型最为常见,占49.4%(40/81);其次为HPV-11型,占39.5%(32/81);HPV-16、18、31、66型各占1.2%(各1例);尖锐湿疣组复发的35例中,18例免疫荧光检测为阳性,早期诊断阳性率51.4%;尖锐湿疣组46例未复发的患者和对照组50例标本免疫荧光检测均为阴性,特异性为100.0%;两组患者敏感性比较,差异有统计学意义(P<0.05)。结论:刮取局部皮肤或黏膜脱落细胞,用免疫荧光技术检测HPV对早期诊断尖锐湿疣有一定的实用价值,特异性强;且免疫荧光技术对尖锐湿疣的复发有一定的预测作用。Objective： To explore the sensitivity and specificity of immunofluorescence detection for latent infection of human papilloma virus and provide new ideas for early diagnosis of condyloma acuminate. Methods： The warts from 81 patients with condyloma acuminatum were removed by CO2 laser and examined histopathologically. Meanwhile,HPV subtypes were detected by PCR-reverse dot blot hybridization in some removed warts; 3 weeks later,immunofluorescence examination was used for exfoliation cells. Relapses were observed for the following 6 months. There were 50 cases in the control group,which were surgically removed normal foreskins of urinary surgery. Results： PCR-reverse dot blot hybridization showed that the condyloma acuminatum group were all HPV-positive,among which HPV-6 subtype was the most common（ 49. 4 %,40/81）,followed by HPV-11 subtype（ 39. 5 %,32/81）,and HPV-16,18,31 and 66 respectively accounting for 1. 2 %（ 1/81）; In 35 cases of recurrent condyloma acuminatum patients,18 cases were immunofluorescence-positive,the early positive diagnostic rate being 51. 4 %; the immunofluorescence detection was negative in 46 relapsed patients and 50 patients in the control group,the specificity being100 %. In terms of sensitivity,the difference between the two groups was statistically significant（ P〈0. 05）. Conclusion： It is practical for early diagnosis of condyloma acuminatum that HPV is detected by immunofluorescence in exfoliation cells from mucosa or scraped local skins. In addition to high specificity,immunofluorescence is a good predictor for condyloma acuminatum relapses.

关 键 词：人乳头瘤病毒 尖锐湿疣 免疫荧光法 早期诊断 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]