实时荧光PCR法在高危型人乳头瘤病毒检测中的应用

Application of real-time fluorescent PCR for detection of high-risk human papillomavirus

目的:评价实时荧光定量PCR技术检测高危型人乳头瘤病毒核酸(HPV-DNA)及其对宫颈上皮内瘤样病变诊断的意义,并对带血标本对测定所产生的干扰进行探讨。方法:应用可同时检测13种高危型HPV DNA的多重荧光定量PCR检测法对110例疑似HPV感染女性患者的宫颈脱落细胞样本进行检测,其中41例与超薄液基细胞学检测法(TCT)的检测结果进行比较。结果:110例样本中,HPV感染率为37.3%(41/110)。实时荧光定量PCR法诊断宫颈癌的灵敏度为88.9%,特异度为48.4%,阳性预测值为33.3%,阴性预测值为93.8%。结论:随着宫颈上皮内瘤样病变程度加重,高危型HPV感染率逐渐增高;实时荧光PCR与TCT法的检测结果相比,敏感性更高,特异性较低,与TCT联合检测对宫颈癌筛查和预防具有较高的临床应用价值,带血标本进行预处理可消除对检测的负干扰。

ObjectiveTo evaluate the significance of real-time quantitative PCR to detect high-risk human papillomavirus DNA （HPV-DNA） and cervical intraepithelial lesions ^ and investigate the interference generated by blood. Methods ： Multiple fluores-cent quantitative PCR was applied to detect HPV DNA of 110 samples from female patients with suspected cervical cell, which could detect 13 types of high risk HPV DNA simultaneously. 41 of the 110 PCR results were compared with those of ultra-thin liquid-based cytology method （TCT） testing. Results： HPV infection rate was 37. 3/^（41/110） on 110 cases. The sensitivity of diagnosis of cervical cancer is 88. 9% , specificity is 48. 4：% , the positive predictive value is 33. 3% , negative predictive value is 93. 8% by real-time fluorescence quantitative PCR Conclusion： With cervical intraepithelial lesion increased, high-risk type HPV infection rate was gradually increased; compared with the results of TCT,real-time fluorescent PCR detection method has higher sensitivity and lower specificity, with the combined detection of cervical cancer screening TCT and prevention of high clinical value; blood samples pretreated would eliminate the negative interference of the test