性传播疾病10联检联合人乳头瘤病毒分型和宿主基因甲基化检测在子宫颈病变筛查中的临床应用  

Clinical application of STD combined with HPV classification and methylation in cervical lesion screening

作　　者：马莉[1] 卞美璐[1] 陈曦 袁记方 邹志远 李茜[1] 于欢[1] 张庆霞[1] 阳艳军[1] 贺桂芳[1] 陈庆云[1] 刘红刚[3] MA Li;BIAN Mei-lu;CHEN Xi;YUAN Ji-fang;ZOU Zhi-yuan;LI Qian;YU Huan;ZHANG Qing-xia;YANG Yan-jun;HE Gui-fang;CHEN Qing-yun;LIU Hong-gang(Department of Obstetrcis and Gynecology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院妇产科,北京100029 [2]广东省人乳头状瘤病毒(HPV)相关疾病分子诊断工程技术研究开发中心,广东广州510555 [3]首都医科大学附属北京同仁医院病理科,北京100730

出　　处：《中国实用妇科与产科杂志》2021年第12期1250-1253,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨性传播疾病(sexually transmitted disease,STD)10联检联合人乳头瘤病毒(human papillomavirus,HPV)分型和宿主基因SOX-1、PAX-1甲基化检测一次性试剂盒在子宫颈癌筛查中的联合应用,评价其对子宫颈病变的筛查效果。方法对2019年10月至2020年1月在中日友好医院子宫颈病变诊疗中心门诊就诊的机会性筛查女性494例,行STD 10联检联合HPV分型和宿主基因SOX-1、PAX-1甲基化检测,根据其就诊情况获得液基细胞学(liquid-based cytologic test,LBC)及组织病理学诊断,以组织病理学诊断为金标准,评价不同筛查方案对组织病理学诊断阳性的筛查效果。结果沙眼衣原体感染是HPV感染的危险因素(χ^(2)=10.925,P=0.001)。HPV感染是甲基化(χ^(2)=29.893,P=0.000)、LBC(χ^(2)=6.607,P=0.012)和组织病理学阳性(χ^(2)=12.641,P=0.000)的危险因素。甲基化阳性与LBC(χ^(2)=33.647,P=0.000)和组织病理学阳性(χ^(2)=41.676,P=0.000)呈现高度的正相关性。HPV分型检测联合甲基化检测进行筛查,可显著提高子宫颈病变的敏感度和阴性预测值,分别为97.6%和96.3%。结论HPV分型检测联合宿主基因SOX-1、PAX-1甲基化检测进行子宫颈病变筛查是可行的,可以在缺乏细胞学检测条件的地区,替代其对子宫颈癌筛查并起分流作用。Objective To investigate the application of the detection of ten types of sexually-transmitted diseases(STD)and detection of human papillomavirus(HPV)genotypes combined with host genes SOX-1 and PAX-1 methylation in cervical cancer screening,and to evaluate the effect.Methods From October 2019 to January 2020,494 cases of opportunistic screening were analyzed,they were from the Diagnosis and Treatment Center of Vervical Lesions of the China-Japan Friendship Hospital.STD ten-combination-detection and HPV genotype detection combined with host genes SOX-1,PAX-1 methylation detection was performed.The diagnosis of liquid-based cytologic test and histopathology were obtained according to the patient’s medical treatment.The histopathological diagnosis was the gold standard to evaluate the screening effectiveness of different screening programs.Results Chlamydia trachomatis infection was the risk factor of HPV infection,(χ^(2)=10.925,P=0.001).HPV infection was a risk factor for positive methylation(χ^(2)=29.893,P=0.000).LBC(χ^(2)=6.607,P=0.012)and histopathology(χ^(2)=12.641,P=0.000).Positive methylation was positively related to positive LBC(χ^(2)=33.647,P=0.000)and histopathology(χ^(2)=41.676,P=0.000).The sensitivity and negative predictive values of detecting cervical lesions were significantly improved by HPV genotyping combined with methylation detection,being97.6%and 96.3%,respectively.Conclusion HPV genotyping combined with host gene SOX-1 and PAX-1 methylation is feasible for cervical lesion screening.In the areas where cytological test is not available,this program can be used to play a shunt role in cervical cancer screening.

关 键 词：子宫颈病变 性传播疾病 人乳头瘤病毒 甲基化 筛查 

分 类 号：R711.3[医药卫生—妇产科学]