HR-HPV病毒载量检测在宫颈细胞学异常患者中的应用价值

Application of high-risk human papillomavirus viral load in women with abnormal cytology

目的探讨高危型人乳头状瘤病毒载量检测在宫颈细胞学异常患者中的应用价值。方法选择宫颈细胞学诊断异常的患者872例,采用杂交捕获二代(Hybridization CaptureⅡ,HC-Ⅱ)进行高危型HPV检测;按宫颈组织病理学结果分为无上皮内病变组(negative for intraepithelial lesion or malignancy,NILM);宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)1、2、3;宫颈鳞癌组(invasive cervical cancer,ICC)。用Spearman等级相关分析HPV病毒载量与宫颈病变级别的关系。结果 NILM组、CIN1、CIN2、CIN3、ICC组HR-HPV阳性率分别为25.2%、53.4%、86.7%、96.4%、100%(P<0.01);不同病理级别组HPV病毒载量有差异(P<0.05),NILM组HPV病毒载量低于CIN各组以及宫颈癌组(P<0.05),CIN以及宫颈癌组HPV病毒载量差异无统计学意义(P>0.05)。结论 HR-HPV病毒载量与CIN以及宫颈癌发生有关,但与宫颈病变的严重程度无关。

Objective To investigate the applicable value of HR- HPV （High- risk Human Papillomavirus, HR- HPV） testing on cervical lesion screening. Methods 872 patients interpreted as abnormal cervical cytology took HR- HPV testing and all patients underwent colposcopy and biopsy. All patients were divided into five groups as NILM, CIN1, CIN2, CIN3 and ICC. Association between HR- HPV load and CIN were evaluated by Spearman rank correlation. Results The positive rate of HR- HPV in NILM, CIN1, CIN2, CIN3 and ICC was 25.2%, 53.4%, 86.7%, 96.4% and 100%, respectively （P〈0.01）. There was significant difference between the viral load in NILM and CIN or ICC, while no significant difference was observed among the viral load in CIN1, CIN2, CIN3 and ICC. Conclusion The HR-HPV viral load is significantly associated with the presence of CIN and ICC, while HPV viral load does not increase with severity of cervical neoplasia.