HPV基因型检测在ASCUS分流中的临床价值

The clinical Value of HPV Genotype Detection in ASCUS Shunt

目的评价HPV基因型检测在ASCUS分流中的临床价值,探索有效分流方法。方法选择2018年1月至2019年11月长治市人民医院妇科门诊宫颈细胞学检查结果为ASCUS的400名患者为研究对象。根据HPV型别将其分为五组,分别为HPV阴性组、低危型HPV组、HPV 16/18组、HPV 16/18混合组(包含HPV 16或18及其他任意型别)、HPV33/52/58混合组(包含HPV 33或52或58及其他任意低危型别),以阴道镜病检结果为"金标准",以高级别鳞状上皮内病变(HSIL)及以上病变为研究终点,分别计算五组对HSIL及以上病变的检出率和除HPV阴性组外的四组分流ASCUS的灵敏度、特异度、阳性预测率、阴性预测率。结果五组对HSIL及以上病变的检出率由低到高依次为HPV阴性组、低危型HPV组、HPV 16/18混合组、HPV 33/52/58混合组、HPV 16/18组;低危型HPV组分流ASCUS的特异性最高;HPV 16/18组分流ASCUS的敏感性和阴性预测率最高。结论低危型HPV组可不转诊阴道镜检查;HPV 16/18组分流ASCUS者的临床价值大于HPV 16/18混合组和HPV 33/52/58混合组。

Objective To evaluate the clinical value of HPV genotype detection in ASCUS shunting and explore an effective method for shunting.Methods From January 2018 to November 2019,400 patients with ASCUS who had received cervical cytological examination in gynecological outpatient department of Changzhi People's Hospital were selected as study subjects.They were divided into five groups according to HPV type:HPV negative group,low risk group,HPV16/18 group,HPV16/18 group(containing HPV16 or 18 and any other type),HPV33/52/58 group(containing HPV33 or 52 or 58 and any other low risk type),based on the results of colposcopy as the gold standard,high-grade squamous intraepithelial lesions(HSIL)and above were the end points of the study,the detection rates of HSIL and above and the sensitivity,specificity,positive predictive rate and negative predictive rate of four shunt ASCUS except HPV negative group were calculated.Results From low to high,the detection rates of HSIL and above diseases were HPV negative group,low risk HPV group,HPV16/18 mixed group,HPV33/52/58 mixed group,HPV16/18 group,the specificity of ASCUS of low-risk HPV was the highest;The highest sensitivity and negative predictive rate of HPV16/18 shunt ASCUS was observed.Conclusion Colposcopy examination is not recommended in the low-risk HPV group,and the clinical value of patients with ASCUS in the 16/18 group is higher than that in the mixed HPV16/18 group and the mixed HPV33/52/58 group.