高危型人乳头瘤病毒感染与宫颈癌前病变的相关性研究  

Relationship between High Risk Human Papillomavirus Infection and Cervical Precancerous Lesions

作　　者：王晓丹 汤丽荣[1] Wang Xiaodan;Tang Lirong(Department of Gynecology Clinic,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科,100026

出　　处：《医学研究杂志》2020年第9期137-140,5,共5页Journal of Medical Research

摘　　要：目的探讨高危型人乳头瘤病毒(HR-HPV)与宫颈癌前病变的关系。方法选取2019年6~12月于笔者医院妇科门诊手术室行阴道镜检查及宫颈活检手术的918例患者作为研究对象,所有患者均于笔者医院妇科行细胞学检查和HR-HPV检测及阴道镜下宫颈定位活检并明确术后病理诊断,并根据阴道镜检查指征将其分为细胞学异常组和HR-HPV阳性组。绘制ROC曲线并比较两组患者的宫颈癌前病变的检出率。结果HR-HPV阳性组患者高级别鳞状上皮内病变的发生率明显高于细胞学异常组,差异有统计学意义(P<0.05);而宫颈原位腺癌的发生率比较差异无统计学意义(P>0.05)。HR-HPV阳性组异常阴道镜所见的检出率明显高于细胞学异常组,差异有统计学意义(P<0.05)。HPV分型敏感度为92.7%,特异性为84.6%,曲线下面积为0.685;阴道镜敏感度为95.1%,特异性为85.7%,曲线下面积为0.709;联合诊断敏感度为99.4%,特异性为89.7%,曲线下面积为0.881。联合诊断曲线下面积明显高于其他,差异有统计学意义(P<0.05)。结论HR-HPV检测阳性时应引起重视,对于有阴道镜检查指征者应及时行阴道镜检查,其感染与高级别鳞状上皮内病变的发病密切相关,但对于宫颈原位腺癌的致病高危因素及如何提高检出率有待于开展进一步的研究。Objective To investigate the relationship between HR-HPV and cervical precancerous lesions.Methods From June 2019 to December 2019,918 female patients were selected from 1608 patients who underwent colposcopy and cervical biopsy in our gynecological outpatient department.All patients underwent TCT,HR-HPV and cervical biopsy under colposcopy.According to the indication of colposcopy,the patients were divided into two groups:the group with abnormal cytology and the group with positive HR-HPV.ROC curve was drawn and the detection rate of cervical precancerous lesions was compared between the two groups.Results The incidence of HSIL in HR-HPV positive group was significantly higher than that in abnormal cytology group(P<0.05).There was no significant difference in the incidence of AIS between two groups(P>0.05).The detection rate of abnormal colposcopy in HR-HPV positive group was significantly higher than that in abnormal cytology group(P<0.05).The sensitivity of HPV typing was 92.7%,and the specificity was 84.6%,the area under the curve was 0.685.The sensitivity of colposcopy was 95.1%,and the specificity was 85.7%,and the area under the curve was 0.709.The sensitivity of combined diagnosis was 99.4%,and the specificity was 89.7%,and the area under the curve was 0.881.The area under the combined diagnosis curve was significantly higher than the other two,and the difference was statistically significant(P<0.05).Conclusion We should pay more attention to the positive detection of HR-HPV,and do colposcopy in time for the patients with colposcopy indications.The infection is closely related to the incidence of HSIL.However,further study is needed on the risk factors of AISand how to improve the detection rate.

关 键 词：高危型人乳头瘤病毒 阴道镜 宫颈癌前病变 

分 类 号：R711.74[医药卫生—妇产科学]