HR-HPV载量在体检女性宫颈病变筛查中的应用价值  

Application value of HR-HPV load in the screening of cervical lesions in women undergoing physical examination

作　　者：黄璐 韦晓英[1] 黄愿静 葛芳玲 陆海渊 李卫[1] HUANG Lu;WEI Xiaoying;HUANG Yuanjing;GE Fangling;LU Haiyuan;LI Wei(Health Management Center,the People's Hospital Guangxi Zhuang Autonomous Region/Institute of Health Management,Guangxi Academy of Medical Sciences,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院健康管理中心/广西医学科学院健康管理研究所,广西南宁530021

出　　处：《临床医学研究与实践》2025年第12期54-57,共4页Clinical Research and Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z-A20220031,No.Z20200679)。

摘　　要：目的探讨高危型人乳头瘤病毒(HR-HPV)载量在体检女性宫颈病变筛查中的应用价值。方法选择2022年1月至2023年12月接受宫颈细胞学与HR-HPV检测的392名体检女性为研究对象。根据宫颈组织病理学诊断结果分为未见上皮内病变或恶性病变(NILM)组、低级别鳞状上皮内病变(LSIL)组和高级别鳞状上皮内病变(HSIL)+组。比较各组的HR-HPV阳性率;分析HR-HPV载量与HR-HPV阳性患者宫颈病变程度的相关性;比较不同年龄段患者的HR-HPV载量表达情况;采用Logistic回归分析探讨HR-HPV载量与宫颈病变的关系。结果NILM组、LSIL组及HSIL+组的HR-HPV阳性率分别为66.43%(95/143)、82.82%(135/163)、82.56%(71/86);三组的HR-HPV阳性率、HR-HPV载量比较,差异具有统计学意义(P<0.05)。LSIL组和HSIL+组的HR-HPV阳性率及HR-HPV载量均高于NILM组(P<0.05)。Spearman相关性分析结果显示,HR-HPV载量与宫颈病变程度呈正相关(P<0.001)。不同年龄段患者中,NILM组、LSIL组与HSIL+组的HR-HPV载量比较,差异具有统计学意义(P<0.05);不同年龄段患者中,HSIL+组的HR-HPV载量高于NILM组(P<0.05);<35岁与>50岁患者中,LSIL组与HSIL+组的HR-HPV载量高于NILM组(P<0.05)。多因素Logistic回归分析结果显示,在校正年龄影响后,HR-HPV载量仍是LSIL与HSIL+的危险因素(P<0.001)。结论HR-HPV载量与宫颈病变程度之间存在一定相关性,在分流宫颈癌筛查中细胞学异常与正常者中具有一定价值,但在区分异常者宫颈病变的具体程度方面临床应用价值有限。Objective To explore the application value of high-risk human papillomavirus(HR-HPV)load in the screening of cervical lesions in women undergoing physical examination.Methods A total of 392 women who underwent cervical cytology and HR-HPV testing from January 2022 to December 2023 were selected as subjects.According to the results of cervical histopathological diagnosis,the subjects were divided into negative for intraepithelial lesion or malignancy(NILM)group,low-grade squamous intraepithelial lesion(LSIL)group and high-grade squamous intraepithelial lesion(HSIL)+group.The positive rate of HR-HPV in each group was compared;the correlation between HR-HPV load and the degree of cervical lesions in HR-HPV positive patients was analyzed;the expression of HR-HPV load in patients of different ages was compared;Logistic regression analysis was used to explore the relationship between HR-HPV load and cervical lesions.Results The positive rates of HR-HPV in the NILM group,the LSIL group and the HSIL+group were 66.43%(95/143),82.82%(135/163)and 82.56%(71/86),respectively;there were statistically significant differences in HR-HPV positive rate and HR-HPV load among the three groups(P<0.05).The HR-HPV positive rate and HR-HPV load in the LSIL group and the HSIL+group were higher than those in the NILM group(P<0.05).Spearman correlation analysis showed that HR-HPV load was positively correlated with the degree of cervical lesions(P<0.001).Among patients of different ages,the HR-HPV load of the NILM group,the LSIL group and the HSIL+group was statistically significant(P<0.05);among patients of different ages,the HR-HPV load of the HSIL+group was higher than that of the NILM group(P<0.05);in patients<35 years old and>50 years old,the HR-HPV load in the LSIL group and the HSIL+group was higher than that in the NILM group(P<0.05).Multivariate Logistic regression analysis showed that HR-HPV load was still a risk factor for LSIL and HSIL+after adjusting for age(P<0.001).Conclusion There is a certain correlation between HR-HPV load

关 键 词：高危型人乳头瘤病毒 宫颈病变 病毒载量 

分 类 号：R737.33[医药卫生—肿瘤]