HR-HPV检测在CINⅢ行宫颈移行区大环切除术后的随访价值  

Follow-up value of HR-HPV test in patients with cervical intraepithelial neoplasia(Ⅲ) treated by large loop excision of the transformation zone

作　　者：王勇 申鸿[2] 张力 曾艳 WANG Yong;SHEN Hong;ZHANG Li;ZENG Yan(Department of Laboratory,Xi'an Beiche Hospital,Xi'an 710086,Shaanxi,CHINA;Department of Laboratory,School Hospital of Xi'an Jiaotong University,Xi'an 710049,Shaanxi,CHINA;Department of Laboratory,Shaanxi Friendship Hospital,Xi'an 710068,Shaanxi,CHINA)

机构地区：[1]西安北车医院检验科,陕西西安710086 [2]西安交通大学医院检验科,陕西西安710049 [3]陕西省友谊医院检验科,陕西西安710068

出　　处：《海南医学》2019年第16期2088-2091,共4页Hainan Medical Journal

摘　　要：目的分析高危型人乳头瘤病毒(HR-HPV)检测在宫颈上皮内瘤变(CIN)Ⅲ行宫颈移行区大环切除术(LLETA)后的随访价值。方法回顾性分析2015年9月至2018年1月间在西安北车医院经过病理诊断和宫颈活检确诊为CINⅢ级并行LLETZ手术的113例患者的临床资料,术后对患者每三个月随访一次,共随访四次,建立随访档案,以HCⅡ法HR-HPV和液基细胞学(LCT)检测作为监测指标,评估HR-HPV结合LCT检测对患者术后的随访价值。结果术后LCT预测病变残留特异度为88.16%,灵敏度为60.03%,阴性预测值为99.20%,阳性预测值为8.28%;HR-HPV对病变残留预测特异度为85.65%,灵敏度为100.0%,阴性预测值为100.0%,阳性预测值为11.09%;LCT对病变复发预测特异度为92.30%,灵敏度为63.59%,阴性预测值为99.19%,阳性预测值为14.02%;HR-HPV对病变复发预测特异度为86.01%,灵敏度为72.68%,阴性预测值为99.40%,阳性预测值为9.28%;术后HR-HPV连续阳性患者病变复发和残留率分别为13.33%、12.50%,明显高于HR-HPV阴性的1.05%、0,差异均有统计学意义(P<0.05)。结论HR-HPV结合LCT检测对病变复发、残留有重要预测价值,是患者有效随诊方法;患者手术后HPV感染状况和复发有密切联系。Objective To analyze the follow-up value of high-risk human papillomavirus(HR-HPV)test in patients with cervical intraepithelial neoplasia(CIN)Ⅲtreated by large loop excision of the transformation zone(LLETZ).Methods A retrospective analysis was performed on clinical data of 113 patients,who were diagnosed as CINⅢby pathological diagnosis and cervical biopsy and who underwent LLETZ surgery at Xi'an Beiche Hospital from September 2015 to January 2018.Patients were followed up every three months for a total of four visits.Follow-up files were established.HCⅡHR-HPV and liquid-based cytological test(LCT)were used as monitoring indicators to evaluate the follow-up value of HR-HPV test combined with LCT.Results For postoperative LCT predicting residual lesions,the specificity was 88.16%,the sensitivity was 60.03%,the negative predictive value was 99.20%,and the positive predictive value was 8.28%.Applying HR-HPV test for residual disease prediction,the specificity was 85.65%,the sensitivity was 100%,the negative predictive value was 100%,and the positive predictive value was 11.09%.LCT for predicting the recurrence of lesions,the specificity was 92.30%,the sensitivity was 63.59%,the negative predictive value was 99.19%,and the positive predictive value was 14.02%.HR-HPV for predicting the recurrence of lesions,the specificity was 86.01%,the sensitivity was 72.68%,the negative predictive value was 99.40%,and the positive predictive value was 9.28%.Postoperative recurrence and residual rate of HR-HPV consecutive positive patients were 13.33%and 12.50%,respectively,which were significantly higher than corresponding 1.05%and 0 of HR-HPV negative patients,with statistically significant differences(P<0.05).Conclusion HR-HPV combined with LCT detection has important predictive value for the recurrence and residue of the disease,and it is an effective follow-up method for patients.HPV infection status is closely related to the recurrence after operation.

关 键 词：宫颈上皮内瘤变 宫颈移行区大环切除术 液基细胞学检测 高危型人乳头瘤病毒 随访价值 复发率 

分 类 号：R713.44[医药卫生—妇产科学]