高危型HPV病毒载量在不同年龄段宫颈癌筛查中的应用研究

The guiding value of high-risk HPV viral load in cervical cancer screening for women of different ages

目的探究高危型人类乳头瘤病毒(HPV)病毒载量在不同年龄段宫颈癌筛查中的不同意义。方法回顾性分析2016年~2020年在唐山市妇幼保健院妇科门诊进行宫颈癌筛查HPV病毒阳性的女性患者1338例,采用二代杂交捕获试验(HC2)进行高危型HPV-DNA检测,并于阴道镜下宫颈多点活检,病毒载量由荧光度数与阴性测定值比值(RLU/CO)来衡量,从组织病理活检结果得到宫颈病变程度。探讨病毒载量在不同年龄段患者,尤其是低年龄与高年龄段中与宫颈病变程度的关系。结果30岁以下组及50岁以上组的病毒载量与30~50岁组比较,差异有统计学意义(P<0.05)。30岁以下HPV阳性患者组中低病毒载量(<100 RLU/CO)比例较高,达74.1%,30~50岁组与50岁以上组中均为高病毒载量比例较高,分别是64.4%和54.7%。30岁以下并携带高病毒载量的患者宫颈病变程度相对更高(P<0.05),而50岁以上的患者携带低病毒载量宫颈病变程度更高(P<0.05)。结论在30岁以下及50岁以上年龄段中,相同病毒载量在宫颈癌筛查工作中有着不同意义,需与30~50岁中年患者的诊治工作做出区分,为未来不同年龄段HPV感染患者的宫颈病变程度进行针对性诊治提供理论依据。

Objective To investigate the different significance of high-risk HPV viral load in cervical cancer screening among different age groups.Methods A total of 1338 consecutive female patients who screened HPV virus positive for cervical cancer at the gynecological clinic of our hospital from 2016 to 2020 were retrospectively screened for high-risk HPV-DNA using the two generation hybrid capture assay(HC2)and cervical multipoint biopsies were obtained under colposcopy,and viral load was measured by the ratio of fluorescence to negative measured value(RLU/CO),The degree of cervical lesion was obtained from histopathological biopsy results.To explore the relationship between viral load and the degree of cervical lesions in patients of different ages,especially in low versus high age groups.Results The viral load in the group younger than 30 years and the group older than 50 years was statistically different from the group aged 30-50 years(P<0.05).The proportion of low viral load(<100RLU/CO)in the group of HPV positive patients younger than 30 years was 74.1%,and the proportion of high viral load was higher in both the 30-50 and older age groups(64.4%and 54.7%,respectively).Patients younger than 30 years and carrying a high viral load had a relatively higher degree of cervical lesions(P<0.05),whereas patients older than 50 years had a higher degree of cervical lesions carrying a low viral load(P<0.05).Conclusion The same viral load in the screening work of cervical cancer in the age group of under 30 years and over 50 years old is different,which needs to be differentiated from the diagnosis and treatment work of middle-aged patients aged 30-50 years,so as to provide a theoretical basis for the future targeted diagnosis and treatment of the degree of cervical lesions in patients with HPV infection in different age groups.