摘要
目的探讨高危型人乳头瘤病毒(HR-HPV)对宫颈癌妇女的早期筛查效果和诊断价值。方法选取2016年7月至2019年6月间北京和美妇儿医院收治的338例宫颈癌筛查HR-HPV阳性患者,行阴道镜检查及活检后,分为宫颈癌早期患者82例为宫颈癌组、宫颈癌前病变患者102例为宫颈癌前病变组及慢性宫颈炎患者154例为慢性宫颈炎组。比较三组患者HR-HPV阳性表达率和不同HR-HPV分型在三组患者中的表达情况,检测HR-HPV及其分型对宫颈病变的预测价值和筛查效果。结果宫颈癌组患者HR-HPV阳性表达率为96.3%,高于宫颈癌前病变组的32.4%和慢性宫颈炎组的7.1%,差异均有统计学意义(均P<0.05)。HPV16在三组患者中阳性率最高,在宫颈癌组患者中阳性表达率为92.7%,其次为HPV18,差异均有统计学意义(均P<0.05)。HR-HPV对宫颈癌早期筛查总灵敏度为93.8%,特异度为85.6%,阳性预测值为5.7%,阴性预测值为99.9%。不同分型中,HPV16和HPV18对宫颈癌早期筛查具有较高的灵敏度和特异度(P<0.05)。结论高危型人乳头瘤病毒对宫颈癌早期筛查有很好的临床效果,其中HPV16和HPV18两种分型临床筛查效果最好。
Objective To explore screening for cervical cancer with high risk human papillomavirus(HR-HPV)testing and the diagnostic value.Methods From July 2016 to June 2019,338 patients with positive HR-HPV were included at Beijing Hemei Women and Children Hospital.Colposcopy and biopsy were performed.Amomg them,82 patients were included in an early stage cervical cancer group,102 patients were included in a cervical precancerous lesion group and 154 patients were included in a chronic cervitis group.Positive rate of HR-HPV expression was compared among the three groups and patients of different HR-HPV types.Predictive value and efficacy of screening were evaluated.Results The positivity rate of HR-HPV expression was 96.3%in the cervical cancer group which was higher than 32.4%of cervical precancerous lesion group and 7.1%of the chronic cervicitis group(all P<0.05).The positivity rate of HPV16 expression was 87.8%which was the highest among the three groups followed by HPV18(P<0.05).The overall sensitivity,specificity,positive predictive value and negative predictive value of HRHPV for early screening of cervical cancer was 93.8%,85.6%,5.7%and 99.9%,respectively.HPV16 and HPV18 had high sensitivity and specificity for early screening of cervical cancer(all P<0.05).Conclusion High risk human papillomavirus testing shows good clinical efficacy for the early screening of cervical cancer,among which HPV16 and HPV18 genotyping shows the best efficacy.
作者
王真
张彦春
WANG Zhen;ZHANG Yan-chun(Department of Obstetrics and Gynecology,Baiziwan Campus,Beijing Hemei Women and Children Hospital,Beijing 100022;Department of Perinatal Health Care,Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University,Beijing Matenal and Child Health Care Hospital,Beijing 100026,China)
出处
《中国肿瘤临床与康复》
2021年第4期422-424,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
高危型人乳头瘤病毒
宫颈肿瘤
早期筛查
High risk human papillomavirus
Cervical neoplasms
Early screening