目的 探讨高危型人乳头状瘤病毒(high-risk human papillomavirus, HR-HPV)检测在宫颈细胞学异常患者中的应用价值。方法 选择2011-01至2012-04宫颈细胞学诊断异常患者872例,采用杂交捕获二代(hybridization captureⅡ,HC-Ⅱ)进行高危型HPV检测;按宫颈组织病理学结果分为NILM组(negative for intraepithelial lesion or malignancy, NILM)、宫颈上皮内瘤变(cervical intraepithelial neoplasia, CIN)Ⅰ、Ⅱ、Ⅲ、宫颈鳞癌组(invasive cervical cancer, ICC)。用Spearman等级相关分析HPV病毒载量与宫颈病变级别的关系。结果 872例细胞学异常患者中ASC-US、ASC-H、LSIL、HSIL组HR-HPV阳性率分别为31.6%、59.7%、50.3%、89.6%;NILM组、CINI、CINⅡ、CINⅢ、ICC组HR-HPV阳性率分别为25.2%、53.4%、86.7%、96.4%、100%,差异有统计学意义(P＜0.01);HC-Ⅱ法诊断宫颈高度病变(≥CINⅡ)的灵敏性、特异性、阳性预告值、阴性预告值分别为93.1%、66.8%、59.9%、94.8%;不同病理级别组HPV病毒载量差异有统计学意义(P＜0.05),NILM组HPV病毒载量低于CIN各组以及宫颈癌组(P＜0.05),CIN以及宫颈癌组HPV病毒载量差异无统计学意义。结论 随着组织病理学级别的升高,HR-HPV阳性率呈上升的趋势;HR-HPV病毒载量与CIN及宫颈癌发生有关,但与宫颈病变的严重程度无关。
Abstract
Objective To investigate the application value of HR-HPV testing in cervical lesion screening. Method 872 patients interpreted as having abnormal cervical cytology received HR-HPV testing and all patients underwent colposcopy and biopsy. The patients were divided into five groups of NILM, CINI, CINII, CINIII and ICC. Association between HR-HPV load and CINs were evaluated by Spearman rank correlation. Result The positive rates of HR-HPV in ASC-US, ASC-H, LSIL, HSIL were 31.6%, 59.7%, 50.3%, 89.6%, respectively(P<0.01). The positive rates of HR-HPV in NILM, CINI, CINII, CINIII and ICC were 25.2%, 53.4%, 86.7%, 96.4%, 100%, respectively(P<0.01). There was significant difference between the viral load in NILM and CINs or ICC,while no significant difference was observed among the viral load in CINI, CINII, CINIII and ICC. Conclusions The positive rate of HR-HPV increases with the gravity of cervical lesion. The HR-HPV viral load is significantly associated with the presence of CINs and ICC. HPV viral load does not increase with severity of cervical neoplasia.
关键词
人乳头状瘤病毒 /
细胞学 /
病毒载量
Key words
human papillomavirus /
cytology /
viral load
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参考文献
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