HPV筛查ws分型对宫颈高度病变的意义

Application of HPV Screening Plus ws Classification in Cervical Lesions of High-risk Pattern

目的:分析探讨人乳头瘤病毒(HPV)筛查ws分型对宫颈高度病变的价值与意义。方法:2013年1月—2014年1月在我院体检和就诊的1 126例育龄期妇女,进行了HPV联合液基薄层细胞学检查(TCT)。对HPV和TCT检测结果任意一项为阳性和两者均为阳性的患者进行阴道镜下多点取材活检。检查结果依据高危型HPV ws分型将患者分为A9,A7,A5/A6 3组;对高危型HPV感染合并宫颈高度病变患者行电子阴道镜下宫颈环形电切术(LEEP)。分别统计宫颈高危型病毒感染发生率、治疗结果及随访预后,比较分析高危型HPV不同ws型感染者不同宫颈病变的分布情况及病变结局。结果:1 126例育龄期妇女(体检和就诊)共检测出14种高危型HPV,高危型HPV检出率为8.5%(96/1 126),高危型HPV不同ws型感染者宫颈病变类型差异无统计学意义(P=0.145)。经过3个月至半年的治疗,高危型HPV感染者总体HPV转阴率是74.0%(71/96),其中A9组的HPV转阴率为78.9%(30/38),A7组的HPV转阴率为67.7%(21/31),A5/A6组的HPV转阴率为74.1%(20/27),3组HPV转阴率比较差异无统计学意义(χ2=3.272,P>0.05)。结论:LEEP疗效确切,高危型HPV不同ws型感染者治疗结果相似。

Objective： To explore the application of the HPV screening combined with Thin Prep cytology（TCT） and loop electrosurgical excision procedure（LEEP） in diagnosis treatment of the cervical lesions of highrisk viral infections. Methods：From January 2013 to January 2014, 1 126 women were tested by HPV testing combined with Thin Prep cytology（TCT） in our hospital. Those patients with positive result（s）（one or two tests）underwent the colposcopic biopsy and pathological exam. Those patients with high-risk HPV were divided into 3groups, A9, A7 and A5/A6, while those patients with high-risk HPV and cervical lesions of high-risk pattern were treated by LEEP knife resection under electronic colposcope. The incidence of high-risk HPV cervical infection, the results of follow-up and treatment and the incidence of different types of cervical lesions in those patients with different high-risk HPV ws classification were compared. Results：Fourteen types of high-risk type HPV were detected in 1 126 women. The incidence of high-risk HPV was 8.5%（96/1 126）. There was not significant difference in the incidences of different types of cervical lesions in those patients with different highrisk HPV ws classification the three groups（P〉0.05）. After three to six months of treatment, the overall rate of the inverted HPV negative infection was 74.0%（71/96）. There was not significant difference in this rate in 3groups difference（the A9 group, 78.9%（30/38）; the A7 group, 67.7%（21/31）; the A5/A6 group, 74.1%（20/27;χ^2=3.272, P〈0.05）. Conclusions：LEEP is a effective method to treat those patients with different high-risk HPV ws classification infection.