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人乳头瘤病毒分型检测对宫颈病变患者的诊断价值

Diagnostic value of human papillomavirus genotyping for the cervical lesions

  • 摘要: 目的: 探讨人乳头瘤病毒(HPV)分型检测在宫颈病变患者诊断中的价值。方法: 选择2013年8月—2015年1月在徐汇大华医院门诊行宫颈癌筛查的妇女,年龄均大于25岁,行宫颈液基薄层细胞学检测(TCT)、核酸扩增荧光PCR检测HPV。患者分为两组:HPV 01(16、35、52、53、58),HPV 02(18、31、33、45、56),共计182例。所有患者进行阴道镜下异常转化区定位活检、病理检查,其中15例行宫颈环形电切术 (LEEP),取其病变较严重者为最终病理诊断。结果: 以病变程度≥ CINⅡ为病理学阳性,以病变程度≤ CINⅠ为病理学阴性,HPV用于筛查≥ CINⅡ病变的敏感度、特异度、阳性预测值和阴性预测值分别为:93.33%、84.43%、35%、99.3%。HPV 01组阳性25例,HPV 02组阳性15例,阴性组142例。15例宫颈上皮内瘤变≥ CINⅡ病变的患者中,TCT检测阳性率为53.33%(8/15),HPV阳性率为93.33%(14/15)。结论: 对于宫颈病变≥ CIN Ⅱ风险更高的患者,TCT联合HPV检测有利于提高其临床检出率。

     

    Abstract: Objective: Type of human papillomavirus (HPV) points detection value in the diagnosis of cervical lesions. Methods: Selection in August 2013-January 2015 in xuhui dahua outpatient women cervical cancer screening, age less than 25 years old, a cerical liquid thin-layer cytology test (TCT), fluorescence PCR detection of HPV for nucleic acid amplification, divided into two groups, HPV01, 35, 52, 53, 58 (16); A total of 298 cases of HPV02, 31, 33, 45, 56 (18).There are indications of selected 182 patients with abnormal transformation zone positioning biopsy under colposcope, pathological examination, including 15 routine cervical Loop electricity cut method (Loop electrosurgieal excision procedure, LEEP), take its pathological changes is more serious for the final pathologic diagnosis. Results: In this study based on acuity CIN lesions Ⅱ for pathology is positive, with the lesion degree CIN I for pathology or less negative, HPV is used for screening or greater CIN Ⅱ lesion degree of sensitivity, specific, positive predictive value and negative predictive value, respectively, 93.33%, 84.43%, 35%, 99, 3 %.Positive HPV01 group 25 cases, positive HPV02 group 15 cases (with 5 positive HPV01 group) at the same time, the negative group 142 cases.In CIN or Ⅱ lesions (a total of 15 cases), 9, 5, and 1 case respectively, compared the risk of cancer, difference of three groups was statistically significant (χ2= 93.98, P< 0.01).For cervical intraepithelial neoplasia acuity CIN Ⅱ lesions of 15 cases, TCT testing positive rate was 53.33% (8/15), HPV detection positive rate was 93.33% (14/15). Conclusions: TCT joint HPV detection, can identify patients with cervical lesions of higher risk CINII or, more should pay attention to the role of HPV clinically.

     

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