二代杂交捕获法检测高危型HPV感染对宫颈病变诊治的临床价值

The clinical value of hybrid capture Ⅱ in test of the high-risk HPV infection in cervical lesions

目的探讨二代杂交捕获法(HC-Ⅱ)检测宫颈脱落细胞高危型HPV感染在诊治早期宫颈病变的临床价值。方法采用HC-Ⅱ方法检测门诊2008-06～2010-06共1 169例患者HR-HPV感染情况,按年龄段和病变程度进行分组,对部分结果异常患者行阴道镜下宫颈活检并与病理组织学对照,分析比较检测结果。结果 HR-HPV-DNA感染阳性率为24.89%(291/1169),其中≤34岁组为30.32%(181/597),≥35岁组为19.23%(110/572),差异有统计学意义(x^2=19.207;P=0.000);宫颈活检率29.60%,病理结果CIN Ⅱ/Ⅲ组HR-HPV感染阳性率为64.29%(18/28),明显高于CIN Ⅰ组37.33%(28/75)和炎症组18.93%(46/243),三组阳性率差异有统计学意义(x^2=32.122;P=0.000);高级别宫颈病变组HPV-DNA载毒量比宫颈炎症组明显高。结论高危型HPV感染在年轻女性患者多见;HC-Ⅱ法检测HR-HPV一定程度可以反映宫颈病变情况,连续HR-HPV检测对早期诊治宫颈病变有重要临床意义。

Objective To explore the clinical value of hybrid capture （ HC-Ⅱ ） in detection of high-risk human papilomavirus （HR-HPV） infection in cervical scraping specimens in early diagnosis and treatment of cervical lesions. Methods Techniques of HC- Ⅱ was used to detect the expression of HR-HPV infection in cervical scraping specimens in 1169 pations from June 2008 to June 2010. All of them were divided into different groups according to age and degree of cervical lesions. Meanwhile, cervical biopsy trader colposcopy for the biology pathology had also been used in some abnormal eases. Results Positive infection rate of HR-HPV-DNA were 24. 89% （291/1169） those in ≤34 years old group and ≥35 years old group were 30. 32% （181/597） and 19. 23% （110/572） ,there was significant difference between the two groups （X2 = 19. 207 ;P = 0. 000 ） ;The rate of cervical biopsy was 29. 60%, positive infection rate of HR-I-IPV-DNA in CIN Ⅱ/Ⅲ, CIN I and inflammation group were 64. 29% （18/28）, 37. 33% （28/75） and 18. 93% （46/243） respectively, which showed significantly higher percentages in CIN Ⅱ/Ⅲ group than those of CIN I and inflammation groups （~ = 32. 122; P = 0. 000）. The viral loads （RLU/PC） of HPV in high-degree group was significantly higher than that in inflammation group. Conclusion HR-HPV infection in young women is more common. HC Ⅱ -HR-HPV test may reflect the degree of cervical lesions, continuous HR-HPV test would have higher clinical value in early diagnosis and treatment of cervical lesions.