HPV-DNA分型检测在宫颈癌前病变早期筛查中的应用价值  

Application Value of HPV-DNA Typing in Early Screening of Cervical Precancerous Lesions

作　　者：高华荣[1] GAO Hua-rong(Gynecology Department,Ganyu District People’s Hospital,Lianyungang,Jiangsu,222100,China)

机构地区：[1]连云港市赣榆区人民医院妇科,江苏连云港222100

出　　处：《黑龙江医学》2022年第2期136-138,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨HPV-DNA分型检测在宫颈癌癌前病变(CIN)早期筛查中的应用价值。方法:选取2017年5月—2020年5月于连云港市赣榆区人民医院收治的疑似CIN需进行病理检测的429例患者作为研究对象,对宫颈分泌物进行人乳头瘤病毒(HPV)DNA分型检测,以组织病理结果作为金标准,分析HPV-DNA分型检测中HPV16/18和高危型HPV在CIN早期筛查中的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)及95%CI。结果:429例受试者经病理学检验CIN阳性有60例,其中HPV16阳性14例、HPV18阳性6例,其他类别HPV阳性49例;HPV-DNA检测对总人群CIN早期筛查效果为高危型HPV灵敏度95.21%(95%CI为88.21%~98.32%),特异度为87.84%(95%CI为86.37%~88.56%),HPV16/18类型合并检测灵敏度为65.88%(95%CI为55.34%~74.94%),特异度为97.48%(95%CI为97.33%~98.24%);对意义不明的不典型鳞状细胞(ASCUS)人群分流效果为高危型HPV灵敏度为90.55%(95%CI为76.26%~96.68%),特异度为78.24%(95%CI为74.76%~81.78%),HPV16/18类型合并检测灵敏度为56.44%(95%CI为39.78%~72.21%),特异度为95.67%(95%CI为93.34%~97.42%)。结论:HPV-DNA分型检测对CIN早期筛查和ASCUS人群分流有着较高的灵敏度和特异度,有很好的临床应用价值。Objective:To explore the application value of HPV-DNA typing in the early screening of cervical precancerous lesions(CIN).Methods:429 patients with suspected CIN who were admitted to the hospital from May 2017 to May 2020 required pathological testing were selected as the research subjects.HPV-DNA typing of cervical secretions was tested,and histopathological results were used as the gold standard.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and 95%CI of HPV-DNA typing in the early screening of CIN were analyzed.Results:60 of 429 subjects were positive for CIN by pathological examination,of which 14 were positive for HPV16,6 were positive for HPV18,and 49 were positive for other types.The effect of HPV-DNA testing on the early screening of CIN in the general population showed that the sensitivity of highrisk HPV was 95.21%(95%CI was 88.21%-98.32%),the specificity was 87.84%(95%CI was 86.37%-88.56%),the combined detection sensitivity of HPV16/18 type was 65.88%(95%CI was 55.34%-74.94%),the specificity was 97.48%(95%CI was 97.33%-98.24%).The shunt effect for the population with unexplained atypical squamous cell(ASCUS)was high-risk HPV,the sensitivity was 90.55%(95%CI was 76.26%-96.68%),the specificity was 78.24%(95%CI was 74.76%-81.78%),the combined detection sensitivity of HPV16/18 type was 56.44%(95%CI was 39.78%-72.21%),the specificity was 95.67%(95%CI was 93.34%-97.42%).Conclusion:HPV-DNA typing test has high sensitivity and specificity for early screening of CIN and ASCUS population shunt,and it has good clinical application value.

关 键 词：HPV-DNA分型检测 宫颈癌前病变早期 筛查 应用价值 

分 类 号：R711.74[医药卫生—妇产科学]