高危型HPV DNA检测在宫颈病变筛查中的价值

Values of high-risk type HPV DNA testing in screening of cervical lesions

目的评价高危型HPV DNA检测在宫颈病变筛查中的价值及相关影响因素。方法对该院2873例妇女采用HPV DNA检测(HPV16、18亚型),筛查结果阳性的女性接受阴道镜检查和病理活检,并以病理结果为金标准。计算不同年龄组(17～34、35～49、50～59岁)、不同地区(农村、城市)、体质量超标组与正常体质量组中HPV DNA阳性率;对研究期间该院共86例病理阳性(CINⅠ、CINⅡ、CINⅢ和鳞状细胞癌)的患者,比较不同病理分型患者中HPV DNA的检出率。结果不同年龄组(17～34、35～49、50～59岁)HPV DNA阳性率分别为36.4%、11.1%、16.3%,17～34岁组与其余两组HPV阳性率差异有统计学意义(P<0.05),而其余两组间差异无统计学意义(P>0.05);农村组与城市组HPVDNA阳性率为27.6%、11.1%,两者差异有统计学意义(P<0.05);体质量超标组与正常体质量组中HPV DNA阳性率为18.0%和15.8%,两组间差异无统计学意义(P>0.05);确诊86例病理阳性患者中,HPV DNA阳性77例,不同病理分型患者中HPVDNA阳性率分别为86.96%、90.00%、91.67%、100.00%,差异无统计学意义(P>0.05),总检出率为89.53%。结论高危型HPVDNA检测在宫颈病变中有重要应用价值,不同年龄组、不同地域之间有显著性差异,HPV阳性检出率随病理分级严重程度呈趋势增高。

Objective To evaluate the value of high-risk type HPV DNA testing in screening of cervical lesions and analyze associated factors.Methods 2 873women of the hospital were detected for HPV DNA （HPV16,18type）.The positive screening results for women were arranged with colposcopy and biopsy.Pathological findings were regarded as the gold standard.Positive rates of HPV DNA were calculated and compared between different age groups （17-34,35-49,50-59years old）,different regions groups （rural,urban）,different bodyweight groups （overweight,normal bodyweight） and different pathological findings groups （CIN Ⅰ,CIN Ⅱ,CIN Ⅲand squamous cell carcinoma）.Results The positive rates of HPV DNA were 36.4%,11.1% and 16.3%in different age groups （17-34,35-49,50-59years old）.And the positwerate in 17-34years old group were significantly different with those in the other two groups （P0.05）,but there was no difference between the other two groups （P0.05）.Positive rates in rural group and urban group were 27.6%and 11.1%,respectively,with significant difference （P0.05）.Positive rates in overweight group and normal bodyweight group were 18.0% and 15.8%,with no significant difference （P0.05）.In 86cases with positive results of pathological detection,77cases were positive with HPV DNA,with positive rates of 86.96%,90.00%,91.67% and 100.00%,and with no statistical difference （P0.05）,and the total positive rate was 89.53%.Conclusion High risk HPV DNA detection might play an important role in cervical lesions screening.There might be significant differences between different age groups and different region groups of HPV positive rate.The positive rate could increase with the increasing of pathological grade.