不同人乳头状瘤病毒检测方法对宫颈高度病变的诊断价值

assays for detection of human papillomavirus infection in diagnosis of high grade cervical lesions

目的 评价杂交捕获Ⅱ代(hc-Ⅱ)与聚合酶链反应(pcr)技术对人乳头状瘤病毒(human papillomavirus,hpv)dna检测及宫颈高度病变的诊断价值.方法 选取宫颈薄层液基细胞学检查(tct)异常的200例妇女为研究对象,同时用hc-Ⅱ、导流杂交基因芯片技术(hybrimax)、实时荧光定量pcr法(fq-pcr)和流式荧光杂交法检测宫颈细胞hpv dna.以病理组织学检测结果为金标准,比较4种检测方法对宫颈上皮内瘤变(cin)≥Ⅱ的诊断效果.采用spss 13.0软件进行统计学处理.结果 hybrimax、fq-pcr、流式荧光法和hc-Ⅱ对200例hpv dna阳性检出率分别为72.5%(145/200)、71.5%(143/200)、70.0%(140/200)和69.0%(138/200).4种hpv dna检测方法对不同程度宫颈病变的hpv检测阳性率差异无统计学意义(x2=0.252、0134、0.012和0.027,p值均＞0.05),但在诊断cinⅡ及以上病变的敏感度、约登指数和阴性预测值等方面比较差异有统计学意义(x2=7.923、7.819和8.108,p＜0.05).结论 对组织病理学诊断结果为cinⅡ及以上的宫颈病变,hc-Ⅱ的诊断价值优于pcr方法. abstract： objective to evaluate the application of different assays for detection of human papillomavirus(hpv)in diagnosis of high grade cervical lesions.methods two hundred subjects with abnormal thinprep liquid-based cytology test(tct)results were selected for hpv dna detection by hybrid capture 2(hc-Ⅱ) and methods based on pcr including flow-through hybridization and gene chip (hybrimax),real-time fluorescent quantitative pcr(fq-pcr)and flow fluorescent hybridization assay.cytopathological results were used as gold standards to evaluate the test performance of the above assays for diagnosing cervical intraepithelial neoplasia(cin)≥Ⅱ. spss 13.0 software was used for statistical analysis.results hpv dna positive rates of 200 samples by hybrimax,fq-pcr,flow fluorescent hybridization assay and hc-Ⅱ were 72.5%(145/200),71.5%(143/200),70.0%(140/200)and 69.0%(138/200),respectively,and the differences were not statistically si(g)nificant(x2 =0.252,0134,0.012 and 0.027,p ＞ 0.05).the sensitivity,youden index and negative predictive value of the above assays were statistically different(x2 =7.923,7.819 and 8.108,p ＜0.05).conclusion hc-Ⅱ is superior to pcr methods in diagnosis of cin Ⅱ and above.

Objective To evaluate the application of different assays for detection of human papillomavirus(HPV)in diagnosis of high grade cervical lesions.Methods Two hundred subjects with abnormal thinprep liquid-based cytology test(TCT)Results were selected for HPV DNA detection by hybrid capture 2(HC-Ⅱ) and Methods based on PCR including flow-through hybridization and gene chip (HybriMax),real-time fluorescent quantitative PCR(FQ-PCR)and flow fluorescent hybridization assay.Cytopathological Results were used as gold standards to evaluate the test performance of the above assays for diagnosing cervical intraepithelial neoplasia(CIN)≥Ⅱ. SPSS 13.0 software was used for statistical analysis.Results HPV DNA positive rates of 200 samples by HybriMax,FQ-PCR,flow fluorescent hybridization assay and HC-Ⅱ were 72.5%(145/200),71.5%(143/200),70.0%(140/200)and 69.0%(138/200),respectively,and the differences were not statistically si(g)nificant(x2 =0.252,0134,0.012 and 0.027,P ＞ 0.05).The sensitivity,Youden index and negative predictive value of the above assays were statistically different(x2 =7.923,7.819 and 8.108,P ＜0.05).Conclusion HC-Ⅱ is superior to PCR Methods in diagnosis of CIN Ⅱ and above.