| 陈跃1 刘青云1 陈国群1 喻利华1 李献忠1 张怡2.人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究[J].,2011,11(12):2328-2330 |
| 人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究 |
| 人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究 |
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| DOI： |
| 中文关键词: 宫颈癌 人乳头瘤病毒 薄层液基细胞学 宫颈上皮内瘤样病变 |
| 英文关键词: Cervical cancer Human papilloma virus Thinprep cytology test Cervical intraepithelial neoplasia |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨高危型人乳头状瘤病毒（HR-HPV）DNA 检测方法在宫颈病变筛查中的应用意义。方法：580 例妇女同时进行薄
层液基细胞学（TCT）、第2 代杂交捕获法（HC II）和阴道镜下宫颈组织活检，并以病理组织学检查结果作为确诊标准进行对比分
析。结果：①580 例受检者中病理诊断为炎症207 例（35.69%），CIN I 224 例（38.62%），CIN II 96 例(16.55%），CIN III 38 例
（6.55%），浸润癌15 例（2.58%）；②TCT 检测异常者中炎症52 例（25.12%），CIN I 177 例（79.02%），CIN II 85 例（88.54%），CIN III
36 例（94.74%），浸润癌15 例（100%），其中CIN II 和CIN III 组间差异无统计学意义（P>0.05），但显著高于炎症组和CIN I 组，低
于湿润癌组（P<0.01 或0.05）；③HPV DNA 检测阳性者中炎症66 例（31.88%），CIN I 152 例（67.86%），CIN II 83 例（86.46%），CIN
III 35 例（92.11%），浸润癌组15 例（100%）, 除CIN II 和CIN III 组间差异无显著性外（P>0.05），其余各组间差异均有统计学意义
（P<0.05 或0.01），且HPV-DNA 检测阳性组CIN 和浸润癌发病率明显高于阴性组(P<0.01)；④30 岁以下高危险型HPV 感染率
（65.53%）显著高于30 岁以上34.47%感染率（P<0.01）；⑤联合应用TCT、HPV-DNA 检测诊断宫颈癌及癌前病变的敏感度和特异
度分别为96.14%和69.28%，高于TCT 或HPV-DNA 的单独检测。结论：宫颈高危险型HPV 感染是CIN 及宫颈癌的主要发病因
素，并与病变严重程度密切相关，而HPV-DNA 和TCT 联合应用可提高宫颈癌及癌前病变的检出率。 |
| 英文摘要: |
| Objective: To evaluate the application of human papillomavirus (HPV) test in screening cervical epithelial lesions.
Methods: 580 cases were tested by thinprep cytology test (TCT), hybrid capture (HC-II) and histopathology, then comparative analysis
was performed by using the results of pathologic examination as diagnosis criteria. Results: ①By pathological examination, 207
(35.69%）, 224 (38.62%）, 96 (16.55%）, 38（6.55%）and 15（2.58%）women were diagnosed as inflammation, CIN I, CIN II, CIN III and
cervical cancer, respectively. ② Among cases with abnormal cytology, 52 （25.12%）were inflammation, 177 （79.02%）CIN I, 85
（88.54%）CIN II, 36 (94.74%）CIN III, and 15 (100%）cervical cancer, and there was a significant difference within groups (P<0.05). ③
Among the HPV DNA positive cases, 66（31.88%）were inflammation, 152（67.86%）CIN I, 83（86.46%）CIN II, 35（92.11%）CIN III, and
15（100%）cervical cancer, and significant difference were found among the groups (P<0.05 or 0.01), but not between CIN II and CIN III
(P>0.05). Notably, the incidence of CIN and cervical cancer in HPV positive group were higher than HPV negative group (P<0.01). ④
HPV detection rates in ≥30 years group was 65.53%, significantly higher than 34.47% in <30 years group (P<0.01). ⑤The combination
of TCT and HPV-DNA test had better sensitivity (96.14%) and specificity (69.28%) than used alone. Conclusion: HPV infection is the
main risk factor for CIN and cervical carcinoma, and plays an important role in the pathogenesis. The combination of HPV-DNA and
TCT could improve detection rate of preinvasive and invasive cervical carcinoma. |
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