宫颈细胞学阴性且高危型人乳头瘤病毒阳性人群的分流方法

Use of Cervista HPV HR A9 group virus to identify patients with negative cytological but positive high-risk HPV

目的分析宫颈细胞学阴性且高危型人乳头瘤病毒(HPV)阳性患者的宫颈活检病理结果,探讨Cervista HPV HR A9组病毒应用于此类人群分流的可行性。方法对1 376例于2011年1月至2016年1月健康查体的女性行新柏氏液基细胞学检测(TCT)和Cervista HPV HR检测,Cervista HPV HR检测结果分为A5/6、A7、A9组,将TCT阴性、HPV阳性患者转诊阴道镜检查,必要时行镜下宫颈活检术,分析A9组病毒感染与宫颈高级别上皮内瘤变CINII+(CINII及CINIII)的关系。结果 A5/6组、A7组及A9组阳性者分别占28.41%、21.51%、50.07%。A5/A6组、A7组及A9组中CINII+的发生率分别为1.28%、3.38%、15.82%,A9组中CINII+的发生率明显高于另外两组,其差异具有统计学意义(P<0.001,P<0.001)。A9组病毒感染者发生CINII+的风险是A5/A6组感染者的12.37倍,是A7组感染者的4.68倍。结论 Cervista HPV HR A9组病毒可用于TCT阴性、高危型HPV阳性者的分流。

Objective To analyze the cervical biopsy results in patients with negative cytological but positive high-risk HR-HPV test results,in order to explore the application of Cervista HPV HR A9 group virus in the identifying of such patients. Methods A total of 1,376 women who took physical examinations in our hospital during Jan. 2011 and Jan.2016 received Cervista HR HPV test plus Thin Prep cytology（ TCT）. They were then divided into 3 groups according to the results of Cervista HR HPV test： A5 /6,A7,and A9 groups. Those who had negative cytological but positive highrisk HPV test results underwent colposcopy or colposcopic biopsy if necessary. The correlation between A9 group virus infection and cervical high-grade intraepithelial neoplasia was analyzed. Results The positive rate in the A5 /6,A7 and A9 group was respectively 28. 41%,21. 51% and 28. 41%. The incidence of CINII＋was 1. 28%,3. 38% and15. 82%,respectively. The incidence of CINII＋in A9 group was obviously higher than that of the other two groups,and the difference was statistically significant（ P〈0. 001,P〈0. 001）. The risk of CINII＋in A9 group was 12. 37 times of that in A5 / A6 group and 4. 68 times of that in A7 group. Conclusion Cervista HPV HR A9 group virus can be used to identify patients with negative cytological but positive high-risk HPV.