高危型HPV检测在宫颈病变中的意义

Significance of detection of high-risk HPV test in diagnosis of cervical lesions

目的探讨高危型HPV检测在宫颈病变中的意义,为预防宫颈癌的发生及早期诊断与治疗提供进一步的指导依据。方法秦皇岛市妇幼保健院2010年5月～2012年5月两年间门诊病人及体检自愿接受宫颈癌筛查的妇女10034例,分别进行第二代杂交捕获技术(HC-II)、液基细胞薄层涂片技术子宫颈脱落细胞学检查(LCT)。结果共有10034名妇女参加本次调查,高危型HPV检出率分别为<20岁组:12.2%,20～30岁组:14.9%,30～40岁组:21.4%,40～50岁组:15.8%,>50岁组:21.6%,出现30～40岁组及>50岁两个高峰期,且各组之间比较差异有统计学意义(P<0.05)。10034例进行筛查的妇女中标本发现异常LCT共925例,占9.2%(925/10034),其中意义不明的不典型鳞状细胞(ASCUS)673例,占6.7%(673/10034),低度鳞状上皮内病变(LSIL)100例,占1.0%(100/10034),高度鳞状上皮内病变(HSIL)144例,占1.4%(144/10034),鳞状细胞癌(SCC)8例。不同类型标本高危型HPV感染情况结果显示:ASCUS、LSIL、HSIL各组间的HPV感染率有统计学差异(P<0.01)。结论将高危型HPV检测与LCT检测技术相结合应用于早期宫颈癌及癌前病变筛查中,提高了筛查宫颈病变的准确性,是防治宫颈癌的关键。

Objective To explore the significance of detection of high-risk HPV in diagnosis of cervical lesions. Methods A total of 10 034 women who received cervical screening voluntarily in outpatient department of Qinhuangdao Municipal Maternity and child care Hospital from May 2010 to May 2012 were selected,then they underwent HPV-DNA detection and LCT. Results The detection rates of high-risk HPV-DNA was 12.2%〈20-year old group, 14.9% ,20-30 year old group：21.4% in 30-40 year old group, 15.8% in 40-50 year old group：21.6% in 〉50 year old group,showing signigicant differences （P〈0.05）;The detection rates of HPV in 30-40 years group and 〉50 years group were significantly higher than those in other groups. Among 10 034 cases,925 cases were found with abnormal smears,accounting for 9.2% ,673 cases were found with atypical squamous cells of undetermined significance （ASCUS）accounting for 6.7%, 100 cases were found with low -grade squamous intraepithelial lesions （LSIL）,accounting for 1.0% ,144 cases were found with high -grade squamous int^aepithehal lesions （HSIL）, accounting for 1.4%, 8 cases were found with squamous cell carcinoma （SCC）. The conditions of different types of high -risk HPV infection specimens showed that there was significant difference in HPV infection rate among ASCUS group, LSIL group, and HSIL group（P〈0.01 ）. Gonclusions High-risk HPV test combined with LCT can be used in screening of early cervical cancer and precancerous lesion of cervix improving the accuracy of diagnosis.