人乳头瘤病毒检测在宫颈癌筛查中的作用

Significance of Human Papillomavirus Detection in Cervical Cancer Screening

目的:了解生殖道人乳头瘤病毒高危型(HPV16/18)感染与宫颈病变、宫颈癌的关系,以便早期发现和治疗宫颈上皮内瘤样变(CIN)和原位癌。方法:利用膜式液基薄层细胞学(TCT)技术筛查与病理学诊断相结合,以宫颈炎为对照组,对宫颈炎和高危患者(如ASCUS、CIN、宫颈原位癌)共685例进行HPV16/18型荧光定量PCR检测。结果:高危患者中HPV16/18感染率为64.2%(124/193),其中宫颈癌、CINⅢ和CINⅡ的HPV16/18感染率为97.2%(69/71),CIN感染率为52.0%(26/50),ASCUS感染率为40.3%(29/72),宫颈炎对照组感染率为11.2%(55/492),宫颈炎和高危患者两组结果比较有统计学差异(P<0.005),高危患者中<40岁感染率为69.0%(40/58),≥40岁感染率为62.2%(84/135),两组结果比较无统计学差异(P>0.05)。结论:高危型HPV16/18感染与宫颈病变,特别是宫颈癌、宫颈癌前病变的发生有明显的相关性,并且病变越重,HPV的感染率越高。提示宫颈癌的防治重点应放在高危型HPV感染者,并且宫颈病变的发生与年龄无相关性。

Objective：To understand the reproduction of high-risk human papillomavirus （HPVI6/18） infection and cervical lesions, cervical cancer, so early detection and treatment of cervical intraepithelial neoplasia （CIN） and carcinoma in situ. Methods：The use of thin-film liquid-based cytology （TCT） technology screening with a combination of pathological diagnosis in order to cervicitis as a control group of cervicitis and high-risk patients （such as ASCUS, CIN, cervical carcinoma in situ） for a total of 685 cases HPV16/18 fluorescent detection quantitative PCR. Results ：HPV16/18 infection in high-risk patients for 64.2% （124/193）, in which cervical cancer, CIN Ⅲ and HPV16/18 of CIN Ⅰ infection rate 97.2% （69/71）, CIN I infection rate was 52.0% （26/50） , ASCUS rate was 40. 3% （29/72）, cervicitis infection control group, 11.2% （55/492）, cervicitis and the results of high-risk patients compared two groups were significantly different （P〈0. 005）, High-risk patients in the infection rate of younger than 40-year-old 69.0% （40/58）, older than or equal to 40-year-old rate was 62.2% （84/135）, two sets of results was no significant difference （P〉 0.05）. Conclusion：HPV16/18 infection and high-risk cervical lesions, especially cervical cancer, the incidence of cervical precancerous lesions apparent relevance, and the more serious lesions, HPV infection rates higher. Cervical cancer prevention and treatment tips should focus on high-risk HPV infection and the occurrence of cervical lesions had no correlation with age.