女性宫颈癌前病变快速HPV基因谱检查的价值研究

Value research of rapid HPV detection in female precancerous lesions of uterine cervix

目的评价人乳头瘤病毒(HPV)检测在筛查女性早期宫颈癌前病变中的临床应用价值。方法采集收治的282例宫颈筛查患者的宫颈脱落细胞,同时进行液基薄层细胞检测(TCT)及HPV基因分型检测。TCT诊断包括无上皮内病变细胞(NILM)、意义不明确的非典型鳞状上皮细胞(ASCUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和鳞状细胞癌(SCC)。对结果异常者进行病理组织活检,以病理组织活检结果为诊断"金标准"。结果 HPV DNA阳性组(126例)TCT诊断NILM 53例,ASCUS 22例,LSIL 32例,HSIL 18例,SCC 1例;病理组织活检阳性率为42.86%(54/126)。HPV DNA阴性组(156例)TCT诊断NILM 133例,ASCUS 16例,LSIL 7例;病理组织活检阳性率为11.54%(18/156)。两组患者病理组织活检阳性率比较,差异有统计学意义(χ2=35.96,P<0.01)。高危型HPV检出率随宫颈病变程度增高而升高。结论对女性早期宫颈癌及其癌前病变的筛查进行HPV检测有重要现实意义。

Objective To evaluate the clinical application values of human papilloma virus （HPV） testing in screening of women precancerous lesions of uterine cervix. Methods Cervical exfoliated cells from 282 hospitalized patients with cervical screening were collected,and the thinprep cytologic test（TCT） and HPV gene type test were conducted simultaneously. The TCT diagnosis included negative for intraepithelial lesion or malignancy （NILM）,atypical squamous cells of undetermined significance （ASCUS）,low-grade squamous intraepithelial lesion（LSIL）,high-grade squamous intraepithelial lesion（HSIL） and squamous-cell carcinoma（SCC）. The histopathologic examination was conducted to the patients with anomalous results,and the result of histopatho logic examination was regarded as golden standard of diagnosis. Results In HPV DNA positive group（n=126）,the TCT showed 53 cases were of NILM,22 of ASCUS,32 of LSIL,18 of HSIL and 7 of SCC with the positive rate of histopathologic examination of 42.86%（54/126）;while in HPVDNA negative group（n=156）,the TCT showed 133 cases were of NILM,16 of ASCUS and 7 of LSIL with the positive rate of histopathologic examination of 11.54%（18/156）. The comparison on positive rate of histopathologic examination between the two groups had statistically significant difference （χ2=35.96,P〈0.01）. High risk type HPV detection rate increased with the increased degree of cervical lesions. Conclusion HPV detection to female early cervical cancer and precan-cerous lesions of uterine cervix has important practical significance.