高危型人乳头瘤病毒基因分型聚合酶链式反应检测技术在宫颈癌筛查中的应用分析

Application analysis of HR-HPV DNA PCR detection technology in cervical cancer screening

目的探讨以聚合酶链式反应(PCR)为基础的高危型人乳头瘤病毒(HPV)分型检测在宫颈癌筛查中的应用和诊断价值。方法选取2016年6月至2019年6月西安航天医院收治的疑似宫颈病变病人628例,分别采取高危型HPV分型PCR技术(HR-HPVDNAPCR),液基薄层细胞学检查(TCT)以及病理组织活检诊断,以病理活检作为诊断宫颈病变的“金标准”,分析高危型HPV感染与宫颈病变的关系以及高危型HPV分型检测技术在宫颈癌筛查中的应用价值。结果HR-HPVDNAPCR技术的灵敏度为91.76%,特异度为91.29%,阳性预测值为9356%,阴性预测值为88.93%,符合率为91.56%,均显著优于TCT检测方法(P<0.001)。同时,对13种HPV亚型分析发现,16、18亚型与宫颈癌及癌前病变密切相关(P<0.05),33、52及58型次之(P<0.05)。而且,HPV的感染率随着年龄的增长而增长,>39~49岁病人HPV感染率为58.15%、>49~59岁病人为64.29%、>59岁病人为75.41%,均显著高于20~29岁的年轻病人的46.40%(P<0.05)。结论高危型HPV持续感染是宫颈癌及癌前病变发生的关键因素,以PCR为基础的高危型HPV分型检测在宫颈癌筛查中具有较高的应用价值。

Objective To investigate the application and diagnostic value of high-risk human papillomavirus(HPV)typing based on polymerase chain reaction(PCR)in the screening of cervical cancer and precancerous lesions.Methods A total of 628 patients with suspected cervical lesions admitted to Xi'an Aerospace General Hospital from June 2016 to June 2019 were selected.High-risk HPV typing PCR(HR-HPV DNA PCR),thinprep cytology test(TCT)and pathological biopsy were used for diagnosis,and pathological diagnosis was used as the"gold standard"for the diagnosis of cervical lesions.The relationship between high-risk HPV infection and cervical lesions was analyzed.Results The sensitivity of HR-HPV DNA PCR technology was 91.76%,the specificity was 91.29%,the positive predictive value was 9356%,the negative predictive rate was 88.93%,and the coincidence rate was 91.56%,which were significantly better than those of the TCT detection method(P<0.001).In addition,13 HPV subtypes were found,16 and 18 subtypes and cervix cancer and precancerous lesions were closely related(P<0.05),followed by 33,52 and 58 subtypes(P<0.05).Moreover,the HPV infection rate increased with age.The HPV infection rate was 58.15%for patients aged>39-49 years,64.29%for patients>49-59 years old,and 75.41%for patients>59 years old,which were significantly higher than 46.40%of young patients aged 20-29(P<0.05).Conclusions High-risk HPV infection is a key factor in the development of cervical cancer and precancerous lesions.High-risk HPV typing has a high value in the screening of cervical cancer and precancerous lesions.