应用HC-Ⅱ法检测宫颈高危型人乳头状病毒479例临床分析

A Clinical Analysis on 479 Cases of High-risk HPV with the Application of HC-Ⅱ

目的分析高危型人乳头瘤病毒（HRHPV）检测结合阴道镜下活检对诊断宫颈病变的意义。方法采用杂交捕获二代（HC-Ⅱ）方法定量检测官颈癌的患者HPV—DNA的含量（以此表示宫颈HPV负荷量）。对其中30岁以上HPV-DNA检测为阳性的妇女在阴道镜下取宫颈活组织检查。结果参加检测的患者共479例。178例阳性患者，阳性率为37％，年龄大于30岁的110例中有94例在阴道镜下取活组织送病理检查。宫颈炎81例（86．2％）。宫颈癌前病变12例（12．8％），包括CINⅠ3例，CINⅠ～Ⅱ2例，CINⅡ1例，CINⅡ～Ⅲ3例，CINⅢ1例。原位癌2例、浸润癌2例。子宫颈炎的HPV—DNA含量为414±38，子宫颈癌前病变及浸润癌的HPV，DNA含量为418±32，两者比较无显著性差异（P〉0．05）。结论采用HC-Ⅱ法检测HPV-DNA，30岁以上阳性患者在阴道镜下取活组织送病理检查，能及早发现宫颈癌前病变和宫颈浸润癌。

Objective To analyze the significance of diagnosing cervical lesion by a combined use of HRHPV and colposcopy and discuss the relationship between HPV load capacity and cervicitis, cervical cancer and precancerous lesion. Methods Making quantitative testing of HPV-DNA with HC- Ⅱ to all the female outpatients who received the gynaecology service in our hospital during the period from November 30,2003 to September 30,2004. They each had a sex life history and volunteered to be involved in our clinical observation. We made colposcopy to those over 30 years of age whose HPV-DNA were positive. Results 178 cases out of 497 cases of subjects were positive, the percentage rate is 37 %. 94 out of the 110 who were over 30 years old were colposcopied for pathological diagnosis. We found that 81 cases were cervicitis（86.2% ）. 12 cases were Cervical precancerous lesion（12.8% ）including 3 cases of CIN Ⅰ ,2 eases of CIN Ⅰ - Ⅱ , 1 case of CIN Ⅱ, 3 cases of CIN Ⅱ-Ⅲ and 1 case of CIN Ⅲ. 2 cases were original place cancer and another 2 cases were infiltrate cancer. The HPV-DNA amount of cervicitis was 414 ± 38 and that of cervical precancerous lesion and infiltrate cancer was 418 ± 32. The parallel difference between the two was not notable （P 〉0.05）. Conclusion Cervical precancerous lesion and cervical infiltrate cancer can be spotted out earlier by adopting HC- Ⅱ to test HPV-DNA of those positive patients who are over 30 years old through colposcopy for pathological diagnosis.