HPV分型检测对宫颈细胞学阴性妇女的诊断价值研究

Diagnostic Values of HPV Subtype Testing on Women with Negative Cervical Cytology

目的探讨高危型HPV分型检测对宫颈细胞学阴性妇女的宫颈病变诊断价值。方法对宫颈细胞学阴性、HPV阳性的妇女436例进行阴道镜检查。根据不同年龄组及不同高危型HPV型别,分为HPV 16/18阳性组,其余HR-HPV阳性组,分析年龄和高危型HPV型别与重度宫颈病变的关系。结果 436例女性中,30～39岁、40～49岁和≥50岁年龄组CIN II+的患病风险分别是<30岁年龄组妇女的2.1、1.5和1.7倍。HPV 16/18型阳性CIN II+患病风险是其余HR-HPV阳性的3.3倍,两组患病率分别为21.59%和7.62%,差异有统计学意义(P<0.01)。结论 HPV分型检测对细胞学阴性妇女的宫颈病变有重要诊断价值。宫颈细胞学阴性、HPV 16/18阳性,建议行阴道镜检查,尤其是年龄≥30岁妇女,有更重要意义。

Objective To explore the diagnosis values of HPV subtype testing on women with negative cervical cytology. Methods 436 women with positive HPV and negative cytology results were enrolled. Subjects were divided into four groups, including 〈 30, 30 - 39, 40 -49 and,≥ 50 year old groups. According to HR - HPV genotyping, the subjects were divided into HPV 16/18 positive group and HR - HPV - positive group. Results The prevalence of CIN Ⅱ ＋ of HPV HPV 16/18 positive group and HR - HPV positive group was 21.59% and 7. 62% respectively. There was significant difference between the two groups （ P 〈 0. 01 ）. The odds ratios of CIN Ⅱ ＋ of 30 - 39, 40 -49, ≥50 years old groups were 2. 1, 1.5 and 1.7 times of 〈30 age group respectively. The odds ratio of CIN Ⅱ ＋ of HPV 16/18 positive group was 3.3 times of HR - HPV positive group. Conclusion HPV genotyping has important diagnostic value for cervical lesions with cytology -negative women, especially when the women was more than 30 years old with HPV 16/18 positive.