高危型人乳头瘤病毒检测在宫颈高度病变诊断中的价值

Investigation on the Value of High-risk Human Papillomavirus Detection for Diagnosing High-grade Cervical Intraepithelial Neoplasia

【目的】探讨高危型人乳头瘤病毒(High-risk Human Pappilomavirus HR-HPV)检测在宫颈高度病变诊断中的价值。【方法】回顾性分析2004年1月至2006年10月在本院宫颈门诊就诊诊断为宫颈高度病变的患者741例,比较其HR-HPV阳性率及宫颈薄层液基细胞学(LCT)异常率。【结果】HR-HPV在宫颈高度病变病人中阳性率为95.9%,而液基细胞学异常者≥低度鳞状上皮内病变(LSIL)502例,占宫颈高度病变病人70.6%;HPV阳性在CIN-Ⅱ中的检出率为94.2%,在CIN-Ⅲ中检出率为97.9%;LCT在CIN-Ⅱ中检出率为60.5%,在CIN-Ⅲ中检出率为71.5%;明显低于HPV的检出率;差异有显著性(P<0.05),HR-HPV与LCT联合应用对宫颈高度病变的检出率在98.5%。【结论】HPV检测可以明显提高宫颈高度病变的检出率,提高细胞学检测敏感性,HR-HPV与液基细胞联合检测是宫颈癌筛查的最佳选择。

[Objective] To investigate the value of human papillomavirus-DNA hybrid capture Ⅱ （HPV DNA HC Ⅱ ） detection for diagnosing high-grade cervical intraepithelial neoplasia（CIN）. [Methods] From Jan, 2004 to Oct. 2006, women in our cervical out-patient clinic were detected for HPV DNA by HC Ⅱ method and the cervical liquid based cytology （LCT） was examined. All cases received biopsy under colposcopy. A total of 741 cases with high grade cervical lesion（CIN Ⅱ - Ⅲ ） were analyzed. [Results] The positive rate of HPV DNA was 95. 9% in patients with high grade cervical intraepithelial neoplasia. There were 472 cases with abnormal LCT and low-grade squamous intraepithelial lesion （LSIL）, which were 63.6 % in patients with high-grade cervical intraepithelial neoplasia. The positive rate of HPV DNA was 94.2 % in CIN- Ⅱ and 97.9 in CIN Ⅲ. The positive rate of LCT was 61.9 % in CIN- Ⅱ and 79.36 % in CIN- Ⅲ , which was lower than the positive rate of HPV DNA. Significant difference was found in specificity （ P 〈0.05 ）. The detection rate of HPV in combination with LCT was 98.5 %. [Conclusion] HPV DNA detection can raise the detection rate of high grade cervical intraepithelial neoplasia and sensitivity of Pap smear. HPV combined with LCT is the opti mal screening approach of cervical lesion.