人乳头瘤病毒分子检测方法在宫颈癌筛查中的应用

Application of HPV molecular detection assays in cervical cancer screening

宫颈癌是女性生殖系统最常见的恶性肿瘤,研究证实宫颈癌的发生与高危型人乳头瘤病毒持续感染密切相关。人乳头瘤病毒感染机制研究和流行病学调查显示早期检测是预防宫颈癌的主要手段。美国食品药品管理局批准认证的人乳头瘤病毒分子检测技术在国内外逐渐应用于宫颈癌的初级筛查以及疫苗接种效果的监测。人乳头瘤病毒分子检测具有较高的阴性预测值,对上皮内瘤变患者具有更高的敏感性,并可延长宫颈癌筛查间隔。然而,临床应用的人乳头瘤病毒检测方法众多,检测技术、检测目标以及检测基因型的不同导致检测结果的一致性存在差异。本文将比较5种美国食品药品管理局认证的高危型人乳头瘤病毒分子检测技术在宫颈癌筛查中的优劣势,针对不同检测结果进行一致性分析,并对年龄分层、高危风险因素等给出不同检测方法的建议。

Cervical cancer is the most common malignant tumor of the female reproductive system.It is reported that persistent infection with high-risk human papillomavirus(hrHPV)is responsible for cervical cancer.HPV infection mechanism study and epidemiological investigation show that early detection is the main means to prevent cervical cancer.Consequently,the HPV detection methods validated by Food and Drug Administration(FDA)have been gradually used for primary cervical cancer screening and HPV-vaccination-effect monitoring at home and abroad.HPV molecular detection has high negative predictive value,high sensitivity to patients with cervical intraepithelial neoplasia(CIN),and can prolong the screening interval of cervical cancer.However,the HPV detection methods fulfilled the criteria of clinical application are numerous,and different detection technologies,detection targets,and detection genotypes result in discordant test results.This paper will compare the advantages and disadvantages of five FDA-validated high-risk HPV detection methods in cervical cancer screening,and analyze the consistency of different detection results,explore the relationship between high-risk risk factors of HPV infection and cervical lesions,and give suggestions on different detection methods.