【摘要】 目的 评价人乳头状瘤病毒(HPV)DNA检测在宫颈癌筛查中的价值。 方法 采用第二代杂交捕获(HCⅡ)技术和液基细胞学测试(LCT)2种方法,对1026例在妇科病中心就诊的受检者进行同步盲法检测,同时进行阴道镜检查。以宫颈活检组织病理学检查结果为诊断标准。评价该方案在宫颈癌筛查中的应用价值。 结果 病理检查结果显示,宫颈上皮内瘤变(CIN)Ⅰ级152例,CINⅡ级108例,CINⅢ级109例,宫颈浸润癌28例。筛查高危型HPV感染366例,阳性率3570%, 在不同宫颈病变中的阳性率分别是:宫颈癌9290%(26/28),CINⅢ900%(99/109),CINⅡ8890%(96/108),CINⅠ8750%(133/152)。高危HPV对宫颈高级别病变的敏感性、特异性、阳性预测值,阴性预测值分别是9860%、8610%、1480%和9980%;HPV与LCT联合检测(平行试验)的以上各指标分别是10000%、8090%、1210%和10000%。 结论 高危型人乳头状瘤病毒检测在宫颈癌前病变的筛查中有较高的敏感度和阴性预测值,联合LCT检测是目前宫颈癌筛查具有诊断价值的方法。
【Abstract】 Objective To investigate the value of high risk human papillomavirus(HPV) DNA dectection for cervical cancer screening. Methods Hybrid capture Ⅱ(HCⅡ)human papillomavirus (HPV) test and liquid based cytology test (LCT) were performed in 1026 patients treaed in Xuzhou No.1 hospital from May 2008 to May 2009,and the abnomal cytological or HPV DNA findings were further biopsied under the colposcopeto to appraise the appicational importance of each approach for screening cervical cancer. Results Pathological results showed that cervical intraepithelial neoplasial(CIN)Ⅰin 152 patients,CIN Ⅱ in 108 patients,CIN Ⅲ 109 patients,invasive cervical cancer in 28 patients.HPV infected 366 patients in detection, with 3570% positive rate. The infection rate of HPV in cervical cancer was 929%(26/28),in CIN Ⅲ was 908%(99/109),in CIN Ⅱ was 889%(96/108),and in CIN Ⅰwas 875%(133/152).The pathological results treated as standard,the sensitivity, soecificiy, positive prevalue, negative prevalue of HCⅡ HPV for detecting highgrade cervical lesions were 986%,861%,148% and 998%.The values for HPVLCT parallel test were 1000%,809%,121% and 100%. Conclusion Highrisk HPV DNA test is of high sensitivity and negativepredictive value. The combination of HCⅡ HPV and LCT tests are of great value for screening cervical cancer at present.
Citation: DING Jing,FAN Youyi,YANG Xiaoming.. The Value of High Risk Human Papillomavirus Detection for Cervical Cancer Screening. West China Medical Journal, 2010, 25(4): 694-. doi: Copy