13种高危型HPV感染联合TCT检查在大理地区宫颈癌筛查中的应用

Application of 13 High-risk HPV infection Test Combined with Thinprep Cytologic Test on Screening Cervical Carcinoma in Dali Region,Yunnan Province

目的分析2 153例患者13种高危型人乳头瘤病毒(HPV)的感染情况和其中1 604例患者行液基细胞学(TCT)检查,以了解云南省大理地区HPV感染联合TCT检查在宫颈癌筛查中的作用.方法应用荧光探针法技术对2 153例患者进行13种高危型HPV检测和对其中1 604例患者行液基细胞学分析,并对上述2种检测的结果进行比较.结果 2 153例样本中,检测HPV阳性260例,阳性率为12.08%;各个年龄段中以>60岁以上感染率最高(18.18%),>20并≤30年龄段的感染(14.41%)次之,不同年龄段样本阳性率差异无意义(P=0.384);在进行TCT检查的1 604例患者中,正常或良性1 465例(91.33%);非典型鳞状细胞(ASC-US和ASC-H)86例(5.36%),低级别鳞状上皮内病变(LSIL)32例(2.00%),高级别鳞状上皮内病变(HSIL)21例(1.31%);HPV检测和TCT检测的相关系数r=0.893(P<0.05).结论云南省大理地区人乳头瘤病毒的感染在各个年龄段的分布差异不明显,HPV和TCT联合应用可以提高宫颈癌的筛查率.

Objective To investigate relativity between the epidemiology of HPV and cervical carcinoma in Dali region, Yunnan province, through detecting the 13 high-risk human papillomavirus infection and Thinprep cytologic test in 2153 cases. Methods Real-time PCR was used to detect the 13 high-risk HPV （16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68） in2153 cases and 1604 cases were cheeked with Thinprep cytologic test. Results In 2153 samples, 260 cases were infected with HPV, with the positive rate of 12.08%. The highest positive rates were 〉60 years old （18.18%） , then 〉20 and ~〈30 years old （14.41%） ; there was no significant difference in the positive rate among the various age groups （P =0.384） There were 1465 negative for intraepithelia[ lesion ormafignancy （NILM） cases （91.33%） , 86 atypical squamous cells of undetermined significance （ASC-US） and atypical squamous cells cannot exclude HSIL （ASC-H） cases （5.36%） , 32 low-grade squamous intraepithelial lesion cases （LSIL） cases （2.00%） , 21 high-grade squamous intraepithelial lesion cases （1.31%） through Thinprep cytologic test. The correlation coefficient is 0.893.Conclusions The infection rate of HPV in Dali region, Yunnan Province, has no significant difference among the various age groups. Application of 13 high-risk HPV infection test combined with Thinprep cytologic test could be more effective in screening cervical carcinoma.