摘要
目的探讨杂交捕获第二代技术（HC2）检测高危型人乳头瘤状病毒DNA（HPV—DNA）与宫颈癌前疾病的关系，评价该技术在宫颈癌前疾病中的临床价值。方法对本院妇科住院的262例慢性宫颈炎患者进行薄层液基细胞学（TCT）、HC2和阴道镜下多点活检，分析其诊断的灵敏度、特异度。结果HC2检查的262例患者中，正常与炎症组、CIN1、CIN2、CIN3和宫颈癌组HPV感染率分别为21．5％、66．7％、90．0％、98．3％、100％；各级宫颈病变HPV感染率差异无统计学意义（P〉0．05），但以20岁一组HPV感染率最高（62．9％），各年龄组HPV感染率差异无统计学意义（P〉0．05）。HC2、TCT及联合两种方法的灵敏度分别为89．4％、53％、92．4％；特异度分别为78．5％、97．7％、76．9％；阳性预测值为80．8％、95．9％、80．3％：·阴性预测值为87．9％、67．2％、90．9％。结论高危型HPV感染与宫颈癌前病变及宫颈癌密切相关，其感染率随着宫颈病变程度的增加而升高。育龄妇女是高危型HPV筛查的目标人群。HC2检测高危型HPV是筛查宫颈癌前病变和宫颈癌的有效方法，联合TCT检查，可有效指导临床诊断。
Objective To explore the relationship between High risk human papilloma virus DNA and precancerous cervical diseases and evaluate the clinic value of hybrid capture 2 （HC2）. Methods 262 patients who had received thinprep cytologic test （TCT）, HC2 and colposcopic biopsy in our hospital were analyzed retrospectively. Results Among the 262 patients, the prevalence of high risk HPV infection with normal and cervicitis, CIN Ⅰ , CIN Ⅱ, CIN Ⅲ, cervix cancer were 21.5% ,66. 7% ,90. 0% ,98. 3%, 100%, respectively. No significant difference was found in patients aged among 20 - 50 （ P = 0. 287）. The histology diagnosis was as criteria and atypical squamous cell of undetermined significance （ASCUS） as a borderline, the sensitivity of HC2, TCT and the combination of the two methods were 89.4%, 53%, 92.4%, and the specificity was 78.5% , 97. 7%, 76. 9%, and positive predictive value was 80. 8% ,95.9% ,80. 3%, and negative predictive value was 87. 9% ,67. 2% ,90. 9%. Conclusion The prevalence of high risk HPV has relationship with precancerous cervical diseases increases along with the severity of CIN. CIN screening would be applied to population of reproductive-age women. High risk HPV test with HC2 is a good method for CIN screening. It＇s more efficient to find out CIN with the combination of HC2 and TCT.
出处
《中国医师杂志》
CAS
2009年第11期1478-1480,共3页
Journal of Chinese Physician
