高危型人乳头状瘤病毒分型检测在宫颈癌及癌前病变中的价值研究

HPV 16 and 18 in the detection of cervical cancer and precancerous lesions

目的:评价高危型人乳头状瘤病毒HPV16,HPV18检测在宫颈癌及癌前病变筛查中的应用价值。方法:以宫颈组织病理学诊断为金标准,采用荧光PCR技术检测筛查360例病例的HPV16,HPV18分型情况,并分别通过传统细胞涂片和液基细胞学法进行验证,比较筛查方法的灵敏性和特异性指标,同时了解永川地区HPV16和HPV18的感染率,评价检测意义。结果:HPV16或HPV18总感染率为41.4%(149/360)。其中HPV16,HPV18阳性率分别为62.4%(93/149)和32.2%(48/149),混合感染率为6%(9/149)。HPV16和HPV18分型的检测方法的灵敏度,特异度,阴性预测值和阳性预测值均高于传统细胞涂片和液基细胞学法,且HPV检测联合液基细胞筛查效能高于联合传统细胞学涂片法。结论:高危型HPV16,HPV18的感染与宫颈癌及宫颈癌前病变密切相关,HPV16,HPV18的检测对筛查、预防宫颈癌,降低宫颈癌发病率有重要作用。

Objectives： To evaluate the clinical value of high -risk human papilloma virus （HPV） 16 and 18 for screening cervical cancer and precancerous lesions. Method： Cervical histopathological diagnosis was used as the gold standard to choose 360 patients. The fluorescence PCR was used to detect HPV 16 and 18. This method was compared with traditional Papanicolaou smears and thinprep cytology test. Sensitivity and specificity were compared among these screening methods. Results： The total infection rate of HPV16 or HPV18 was 41.4% （149/ 360）. The infection rate of HPV16, 18 or 16 and 18 combined was 62.4% （93/149）, 32.2% （48/149） and 6% （9/149） respectively. Compared with Papanicolaou smears and thinprep cytology test, the screening method of HPV 16 and 18 detection was associated with higher sensitivity, specificity, positive predicted value and negative predicted value. In addition, HPV combined with thinprep cytology test showed higher efficiency than HPV combined with Papanicolaou smears. Conclusion： HPV 16 and 18 infection is closely associated with cervical cancer and precancerous lesions, and the detection of HPV 16 and 18 is useful to screen cervical cancer and decrease the prevalence rate of cervical cancer.