2784例同步HPV分型及标准化定量检测预测高危型HPV感染转归的临床研究  

Synchronous HPV genotyping and quantification assay to predict the outcome of high risk HPV infection:report of 2784 cases

作　　者：龙馨[1] 杨君[1] 周德平[1] 何萍[1] 刘建双[1] LONG Xin;YANG Jun;ZHOU Deping;HE Ping;LIU Jianshuang(Cervical Diseases Diagnosis&Treatment Center,Chongqing Health Center for Woman and Children,Chongqing,401147,China)

机构地区：[1]重庆市妇幼保健院宫颈疾病诊治中心,重庆401147

出　　处：《第三军医大学学报》2020年第15期1555-1561,共7页Journal of Third Military Medical University

基　　金：重庆市科学技术委员会技术创新与应用示范项目(CSTC2018jscx-msyb0377)。

摘　　要：目的探讨高危型人乳头瘤病毒感染(high risk human papillomavirus infection,HR-HPV)的自然转归规律,确立同步HPV分型及标准化定量检测预测HR-HPV感染转归的最佳阈值。方法采用同步HPV分型及标准化定量检测对初次检出单一型别HR-HPV感染的2784例女性进行跟踪随访2年,分析HPV标准化定量与感染转归的关系,绘制ROC曲线确立HPV标准化定量预测HR-HPV持续感染的最佳阈值。结果2784例女性HR-HPV自然消退率为73.71%,持续感染率为20.26%,进展率为6.03%。13种HR-HPV标准化定量在HPV感染自然消退组、持续感染组及进展组中相比差异有统计学意义(H=673.943,P<0.001)。根据ROC曲线建立同步HPV分型及标准化定量检测预测高危型HPV感染转归的最佳阈值,Log10转化的病毒标准化定量预测HPV16、18、33、52、58、59、68型持续感染的最佳阈值为3.00拷贝数/10000个细胞,预测HPV31、39、51、56型持续感染的最佳阈值为4.00拷贝数/10000个细胞,预测13种HR-HPV持续感染的最佳阈值为3.00拷贝数/10000个细胞,敏感度为88.66%,特异度为59.36%(P<0.001)。结论HPV标准化定量可以作为一种生物学指标,用于预测女性生殖道HR-HPV感染的转归。Objective To explore the law of natural outcome of high-risk human papillomavirus(HR-HPV)infection and determine the optimal cutoff for prediction of the infection natural outcome based on the synchronous HPV genotyping and quantification.Methods A total of 2784 women who underwent primary cervical screening with single type HPV infection for the first time by the synchronous HPV genotyping and quantification assay were enrolled and followed up for 2 years in this study.The correlation between standardized quantification and HR-HPV infection natural outcome was analyzed.Receiver operating characteristic(ROC)curve was plotted to determine the optimal cutoffs of individual HR-HPV standardized quantification in prediction of persistent infection.Results Among all the subjects,the natural clearance rate of HR-HPV infection was 73.71%,the persistent infection rate was 20.26%and the progression rate was 6.03%.Statistical differences were observed in the 13 HR-HPVs standardized quantifications among the natural clearance group,persistent infection group,and progression group(H=673.943,P<0.001).The best threshold of the synchronous HPV genotyping and quantification assay to predict the outcome of HR-HPV infection was established according to ROC curve,and the optimal cutoffs of the log10-transformed quantification for HPV16,18,33,52,58,59 and 68 in prediction of persistent infection were 3.00 copies per 10000 cells,those for HPV31,39,51 and 56 were 4.00 copies per 10000 cells.The optimal cutoff of the log10-transformed quantification for 13 HR-HPVs in prediction persistent infection was 3.00 copies per 10000 cells,and the sensitivity was 88.66%and the specificity was 59.36%(P<0.001).Conclusion HR-HPV standardized quantification can be used as a biological maker to predict the outcome of HR-HPV infection in the genital tract of female.

关 键 词：人乳头瘤病毒 标准化定量 转归 

分 类 号：R181.32[医药卫生—流行病学] R373.9[医药卫生—公共卫生与预防医学]