摘要
目的探讨延边地区妇科门诊患者人乳头瘤病毒(HPV)感染亚型分布与宫颈病变的关系。方法选取2011年6月-2017年5月在延边大学附属医院门诊行宫颈HPV分型及薄层液基细胞学(TCT)筛查的患者13720例,其中HPV分型检测呈阳性者4219例,细胞学阳性者[≥未确定意义的不典型鳞状细胞(ASCUS)]1209例;对薄层液基细胞学阳性结果者行阴道镜下组织病理学检查,共1209例。根据病理检测结果,分析HPV感染亚型与宫颈病变的相关性。结果HPV阳性率为30.75%(4219/13720),其中最常见的基因型为HPV16、52、58、53及39型。各年龄组HPV阳性率比较,差异有统计学意义(χ^2=126.681,P<0.01),其中≤20岁年龄组阳性率最高。TCT阳性率为8.81%(1209/13720例),共1209例患者进行了病理检测,504例病理诊断阳性。按TCT和不同病变类型分组,将高危亚型HPV(HR-HPV)阳性率进行趋势χ^2检验,结果均显示随病变程度增加,HR-HPV阳性率呈增高趋势,差异均有统计学意义(均P<0.01)。以病理诊断为金标准,HR-HPV DNA检测的灵敏度、特异度、阳性预测值分别为88.70%(102/115)、80.00%(20/25)、95.33%(102/107)。结论延边地区妇科门诊患者高危型HPV感染的主要型别依次为HPV16、52、58、53及39。HR-HPV在宫颈癌及癌前病变的发生和发展中起关键作用。高危型HPV基因分型诊断在宫颈癌筛查及防治过程中具有重要意义。
Objective To discuss HPV infection subtype distribution among gynecological outpatients in Yanbian district and its relation with cervical lesions.Methods Until June 2011 to May 2017,totally 13720 outpatients undergoing HPV genotyping and thinprep cytological testing(TCT)were selected in Yanbian university hospital in Yanbian district.There were 4219 cases with HPV genotype positive and 1209 cases with cytological positive(ASCUS).For 1209 patients with TCT positive results,colposcopy and cervical biopsy were performed.The correlation between subtypes of HPV infection and cervical lesions was analyzed according to pathological examination results.Results The positive rate of HPV was 30.25%(2119/13720),the major HPV genotypes were HPV 16,52,58,53 and 39 type.HPV positive rates were statisticaly different among different age groups(χ^2=126.681,P<0.01),positive rate was highest in≤20 years old age group.Positive rate of TCT was 8.81%(1209/13720 cases),a total of 1209 patients were performed pathological detection,504 were positive.Patients were divided according to different to different TCT and different lesion type,χ^2 testing of high-risk HPV(HRHPV)positive rate showed that positive rate of HR-HPV had a increasing tendency with the increase in severity of diseases(all P<0.01).Pathological detection was a gold standard,the sensitivity,specificity,positive Predictive Value of HR-HPV was 88.70%(102/115),80.00%(20/25)and 95.33%(102/107).Conclusion The most common HR-HPV genotypes infected in outpatients in Yanbian district are HPV 16,52,58,53,39.HR-HPV plays a key role in the genesis and development of cervical cancer and precancerous lesions.High-risk HPV genotyping is therefore very important in cervical cancer screening and the process of prevention and diagnosis.
作者
韩龙哲
权春姬
张美兰
张英哲
沈哲式
金雪梅
HAN Long-Zhe;QUAN Chun-Ji;ZHANG Mei-Lan(Department of Pathology,Affliated Hospital of Yanbian University,Yanbian,Jilin 133000,China)
出处
《中国妇幼保健》
CAS
2019年第21期5012-5015,共4页
Maternal and Child Health Care of China
基金
国家自然科学基金(81860043)
