高危型HPV-DNA检测在意义不明的非典型鳞状细胞患者分流管理中的研究  

Study of high-risk HPV-DNA detection on the application of shunting management of patients with atypical squamous cells of undetermined significance

作　　者：古力米热.乃扎尔 帕提曼.米吉提 古扎丽努尔.阿不力孜 Gulimire Naizher;Patiman Mijiti;Guzhalinuer Abuliz(Department of Three Gynecology,Xinjiang Medical University,Urumqi 830011,China;Department of Five Gynecology,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三科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院妇外五科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2018年第10期1243-1247,共5页Journal of Xinjiang Medical University

基　　金：新疆医科大学科研创新基金(XYDCX201651)

摘　　要：目的探讨care HPV及HC2(Hybrid Capture 2)高危型HPV-DNA检测在意义不明的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)患者分流中的应用及意义。方法 2016年6月-2017年8月间新疆医科大学附属肿瘤医院就诊的120例ASC-US女性进行care、HC2HPV检测及阴道镜下宫颈活检。结果全部的病例中,病理活检为鳞状细胞癌4例,CINⅡ以上病变检出率为23.33%(28/120);HC2高危型HPV-DNA检测阳性组与阴性组高级别病变检出率分别为37.7%和3.9%(P <0.01);care HPV阳性组与阴性组的高级别病变检出率分别为37.5%和7.1%(P <0.01);HC2与care HPV的Kappa值为0.815,有较好的一致性;以组织病理诊断为金标准,HC2及care HPV检测预测高级别病变的敏感度、特异度、阳性预测值、阴性预测值分别为92.9%、53.3%、37.7%、96.1%;85.7%、56.5%、37.5%、92.9%;HC2和care HPV检测在ROC曲线下面积分别0.731、0.711,2种方法 ROC曲线下面积基本相近。结论高危型HPV检测技术对ASC-US患者有很高的检测效果,此类患者中care及HC2HPV检测的一致性高,均可预测CINⅡ以上病变及浸润癌,可提高诊断率,临床上可以推广。Objective To explore the application and significance of care HPV and HC2 high risk HPV-DNA detection in atypical squamous cells of undetermined significance(ASC-US)patients.Methods A total of 120 ASC-US women in the Affiliated Tumor Hospital of Xinjiang Medical University from June 2016 to August 2017 were measured with care HPV,HC2 HPV-DNA and cervical biopsy under colposcopy.Results Pathological biopsy showed there were 4 cases of squamous cell carcinoma(SCC),and the incidence of lesion above CIN(CINⅡ,CINⅢ)was 23.33%(28/120);HC2 HPV positive group and negative group with high grade lesion detection rates were 37.7%and 3.9%respectively(P<0.01);care HPV positive group and negative group of high grade lesion detection rates were 37.5%and 7.1%respectively(P<0.01),HC2 and care HPV have good consistency with Kappa:0.817;taking pathological diagnosis as the gold standard,the sensitivity,specificity,positive predictive value,high grade lesion negative predictive value of HC2 HPV detection were 92.9%,53.3%,37.7%and 96.1%,and care HPV′s were 85.7%,56.5%,37.5%and 92.9%;the area under ROC curve of HC2 HPV was 0.711,and care HPV′s was 0.711;the area under ROC curve of the two methods was basically similar.Conclusion High-risk HPV-DNA detection technique can be used in the distribution management of ASC-US population,which plays an important role.The detection of care HPV and HC2 HPV in the population shunting of ASC-US patients is consistent,so HC2 HPV detection can predict the pathological changes and invasive carcinoma of CINⅡ,and can improve the diagnosis rate,which can be popularized in clinical.

关 键 词：不能明确意义的非典型鳞状上皮细胞 careHPV HC2高危型HPV-DNA检测 CINⅡ以上病变 诊断 

分 类 号：R446.11[医药卫生—诊断学]