人乳头瘤病毒DNA、p16^(INK 4 A)联合检测对子宫颈腺癌的诊断意义及预后分析

Diagnostic significance and prognosis of cervical adenocarcinoma by combined detection of HPV DNA and p16^(INK 4 A)

目的研究人乳头瘤病毒(human papillomavirus,HPV)DNA、p16^(INK 4 A)联合检测对子宫颈腺癌的诊断意义及预后分析。方法选择2016年3~9月在河西学院附属张掖人民医院就诊的96例子宫颈腺癌和89例子宫内膜腺癌患者,共185例,将患者的子宫颈及内膜分泌物平均分为3份。观察组:对患者分泌物采用HPV DNA、p16^(INK 4 A)联合检测。对照组1:对患者分泌物应用PCR反向杂交检测,HPV-DNA≥1.0 ng/L判定为阳性。对照组2:采用单纯p16^(INK 4 A)检测。比较3组的阳性检出率,比较同一方法对不同疾病诊断的准确率,研究HPV DNA、p16^(INK 4 A)联合检测对子宫颈腺癌的诊断意义及预后分析。结果 (1)对子宫颈腺癌检测,观察组和对照组1、对照组2阳性率分别为81.25%、67.70%、63.54%,观察组和对照组1、2比较差异均有统计学意义(P<0.05)。(2)对子宫内膜腺癌检测,观察组、对照组1、对照组2阳性率分别为73.03%、44.94%、49.43%,观察组和对照组1、组2比较差异均有统计学意义(P<0.05)。(3)观察组对不同子宫内膜腺癌和子宫颈腺癌鉴别准确率均高于单纯HPV DNA检测和p16^(INK 4 A)检测。结论 HPV DNA、p16^(INK 4 A)联合检测无论是对不同疾病鉴别诊断还是对同一疾病诊断阳性率均高于单独HPV DNA检测和p16^(INK 4 A)检测。HPV DNA、p16^(INK 4 A)联合检测对子宫颈腺癌诊断意义及预后分析有较好效果,值得推广。

Objective To investigate the diagnostic significance and prognosis of HPV DNA and p16 ～（ INK 4 A） combined detection for cervical adenocarcinoma. Methods A total of 96 patients with cervical adenocarcinoma and 89 patients with endometrial adenocarcinoma who were admitted to the Zhangye People＇s Hospital Affiliated to Hexi University from March to September 2016,a total of 185 patients,were divided of the cervix and endometrial secretions into 3 Share. Control group 1： The patient ＇s secretions were detected by PCR reverse hybridization,and HPV-DNA ≥ 1. 0 ng/L was judged to be positive. Control group 2： using p16 ～（ INK 4 A）alone. The positive detection rates of the 3 groups were compared. The accuracy of the same method for different diseases was compared. The diagnostic significance and prognosis of HPV DNA and p16 ～（ INK 4 A） combined detection for cervical adenocarcinoma were studied. Results （1） For cervical adenocarcinoma,the positive rates of observation group,control group 1 and 2 were 81. 25 %,67. 70 % and 63. 54 %,respectively,the differences were statistically significant（ P〈0. 05）. The observation group and two control groups were compared,the differences were statistically significant（ P〈0. 05）.（2） For the detection of endometrial adenocarcinoma,the total positive rate of the observation group was 73. 03 %,the positive rate of the control group 1 was 44. 94 %,the difference was statistically significant（ P〈0. 05）,and the positive rate of the control group 2 was 49. 43 %. The observation group and two control groups compared,the difference was statistically significant（ P〈0. 05）.（3） The accuracy of the identification of different endometrial adenocarcinoma and cervical adenocarcinoma in the observation group was higher than that of HPV DNA detection and p16～（ INK 4 A） alone. Conclusion The combined detection of HPV DNA and p16 ～（ INK 4 A） is superior to HPV DNA detection and p16 ～（ INK 4 A） detection in the differential diagnosis of different diseases or the positive rate of the same disease. The combined detection of HPV DNA and p16 ～（ INK 4 A） has a good effect on the diagnosis and prognosis of cervical adenocarcinoma,and it is worthy of promotion.