原位杂交HPV16/18检测在宫颈癌及癌前病变诊断中的作用

The effect of HPV16/ 18 testing by in situ hybridization in diagnosing precancerous disease and cervical cancinoma

目的探讨人乳头瘤病毒(HPV)检测在宫颈癌及癌前病变诊断中的作用。方法用液基细胞检测法(TCT)进行宫颈细胞学检查。对651例细胞学检查异常者,均采用原位杂交检测高危型HPVDNA,对其中194例同时采用阴道镜下活组织病理检查,分析原位杂交HPVDNA检测对宫颈癌的诊断作用。结果1)651例细胞学检查异常患者,HPV感染率为39.6%,非典型鳞状细胞(ASCUS)患者中,HPV检出率为28.7%。HPVDNA检出率随宫颈TCT检查病变程度加重逐渐升高。2)在TCT检测基础上,HPV检测诊断宫颈上皮内瘤变(CIN)及宫颈癌的敏感性为77.9%,特异性为70.4%。结论HPVDNA检测在宫颈TCT检测基础上,可提高宫颈癌前病变及宫颈癌诊断率,为轻度细胞学异常患者是否进一步采用阴道镜病理检查提供依据。高危型HPV检测可指导早期感染者的治疗及随访观察。

Objective To investigate the effect of hmnan papillomavims（HPV） in diagnosing precancerous disease and cervical cancinoma. Methods All cytological specimens were treated using Thinprep Cytology Test （TCT）. The patients whose TCT result was abnormal cell morphology were tested HPVDNA by in situ hybridization. The 193 among 651 patients undergo colposcopy pathology examination together. Results 1. The positive rate of HPV is 39.6 % among 65 1 abnormal cell morphology patients by TCT exam and 28.7% in ASCUS patients.The HPV infective rate will increase with the degree of the cervical disease tested by TCT.2.The sensitivity of HPV testing was 77.9%, specific was 70.4% on the basis of TCT. Conclusion HPVDNA testing can improve the diagnostic accuracy on the basis of TCT and provide the basis to carry colpaacopy pathology examination among the ASCUS and LSIL patients. Earlier detection of high-risk HPV types can instruct the treatment and follow-up of the infected patients.