HPV基因分型、宫颈刮片及阴道镜检测在宫颈病变筛查中的应用

The application of HPV genotyping and PAP smear and colposcopy in the diagnosis of cervical cancer and precancerous lesions

目的对疑似人乳头瘤病毒(HPV)感染的259例患者进行HPV基因分型、宫颈刮片和阴道镜检查,以探讨其临床意义。方法对发现宫颈异常的患者同时进行HPV检测、宫颈刮片及阴道镜检查,1项或多项异常者行病理组织学检查,并以病理结果为金标准,比较3种方法的检出敏感性、特异性、阳性预测值和阴性预测值。结果 259例患者中共有61例病理检测结果阳性,占23.55%。61例宫颈病理检测阳性标本中有51例HPV检测阳性,敏感性为83.6%,特异性为57.6%,阳性预测值为53.6%,阴性预测值为87.69%;18例宫颈刮片结果阳性,敏感性为29.5%,特异性为88.38%,阳性预测值为52.08%,阴性预测值为82.94%;37例阴道镜检查阳性,敏感性为60.7%,特异性为70.71%,阳性预测值为36.26%,阴性预测值为83.3%。三者相比差异有统计学意义(P<0.05)。结论对于宫颈癌及其癌前病变的筛查及早期诊断,应以HPV检测、宫颈细胞学及阴道镜检查相互结合,以提高检出率。

Objective To detect the HPV genotyping,PAP smear and colposcopy in 259 women who were suspected to be HPV infection,and to investigate the clinical significance. Methods The patients were detected by PAP smear, colposeopy and HPV genotyping simultaneously,any case of abnormal test were diagnosed pathologically. Sensitivity of three methods were compared with each other. Results 18 cases were positive in PAP smear,their sensitivity was 29.5 % ,whereas 37 cases were positive in colposcopy,their sensitivity was 60.7%. And there were 51 cases with HPV-DNA positive. The difference among the three methods was significantly. Conclusion We should integrate HPV genotyping,PAP smear and colposcopy in diagnosis of cervical cancer to increase the positive rate.