摘要
目的 探讨高危型HPV病毒和宫颈病变的相关性,分析运用HC-Ⅱ法筛查宫颈病变的临床应用评价.方法 应用非配对病例对照研究方法,统计分析在佛山中医院宫颈病-宫颈癌筛查防治中心同时做病理活体组织检查和HR-HPV DNA检测的893例病例.依据病理组织检查结果,分为无宫颈病变的正常组(对照组)和有宫颈病变的病变组.宫颈病变包括CIN-Ⅰ,CIN-Ⅱ,CIN-Ⅲ和SCC.对照分析全部资料的HR-HPV DNA结果,单因素分析HR-HPV与宫颈病变的相关性,统计HC-Ⅱ法筛查宫颈病变的灵敏度、特异度、阳性预测值和阴性预测值.结果 组病例HR-HPV DNA阳性率分别是:正常组32.18%(223/693),CIN-Ⅰ 53.66%(66/123),CIN-Ⅱ 78.72%(37/47),CIN-Ⅲ 93.10%(27/29)和SCC组100.00%(1/1).各级病变与HR-HPV感染的比值比(OR)、归因危险度百分比(PAR%)分别是:CIN-Ⅰ级2.44,31.64%;CIN-Ⅱ级7.80,69.12%;CIN-Ⅲ级28.46,90.48%;高度瘤样变(CIN-Ⅱ及CIN-Ⅲ)11.42,72.73%.HC-Ⅱ法筛查宫颈病变的灵敏度为65.51%,特异度为67.83%,阳性预测值为36.81%和阴性预测值为87.19%.结论 高危型HPV感染与宫颈上皮瘤样变的发生密切相关,随宫颈病变程度的加重,相关性增加,感染率也增加;HC-Ⅱ筛查方法的最大价值在于对宫颈病变的阴性预测值,筛选出易患宫颈病变的高危人群.
Objective To explore high-risk HPV virus and the relationship between cervical lesions,and analyse the use of HC-II method of laboratory evaluation of screening for cervical lesions. Methods Application of non-matched case-control study, statistical analysis of cervical disease in Foshan hospital-prevention and treatment of cervical cancer screening center at the same time to do pathology biopsy and HR-HPV DNA detection of 893 cases. Based on the results of histopathological examination,no cervical lesions were divided into normal group (control group),there were cases of cervical lesions group. Cervical lesions,including CIN-I ,CIN-II ,CIN-III and SCC. Comparative analysis of all the information the results of HR-HPV DNA,single-factor analysis of HR-HPV and cervical lesions associated statistical HC-II method of screening for cervical lesions sensitivity, specificity, positive predictive value and negative predictive value. Results Patients in each group HR-HPV DNA positive rates were as follows : normal group 32.3 % (223/693), CIN-I 53.7 % (66/123), CIN-II 78.7% (37/47),CIN-III 93.1% (27/29) and SCC group 100% (1/1). Lesions at all levels of HR-HPV infection with odds ratio (OR) ,attributable risk percent (PAR % ) were :CIN-I level 2.44,31.64 % ;CIN-II-class 7.80,69.12 % ;CIN-III- class 28.46,90. 48% ;a high degree of CIN (CIN-II and III) 11.42,72. 730/00. HC-II method of the sensitivity of screening for cervical lesions was 66.5% ,the specificity was 67.8% ,positive predictive value was 37.0% and negative predictive val- ue of 87.2%. Conclusion High-risk HPV infection and cervical intraepithelial neoplasia was closely related to the occur- rence of change. With the severity of cervical disease,the relevance of increased rate of infection had also increased. HC-II screening methods of the greatest value lies in the negative predictive value of cervical lesions ,filter out high-risk groups susceptible to cervical lesions.
出处
《现代检验医学杂志》
CAS
2010年第5期85-87,共3页
Journal of Modern Laboratory Medicine
基金
佛山市卫生局课题《高危型HPV定量检测在宫颈癌及癌前病变筛查中的作用》内容,课题号:2004416.
关键词
HC-Ⅱ基因杂交信号放大技术
子宫颈上皮瘤样变
人乳头瘤病毒
genetic hybrid capture signal amplification technology
cervical intraepithelial neoplasia
human papillomavirus