FQ-PCR检测宫颈涂片剩余细胞内HPV16、18型感染的临床意义

Clinilal Significance of Using Cervical Cytological Specimens To Detecting Human Papillomaviruses Type 16、18 Infections by Flurescence Quantitative PCR Assays

目的 :探讨实时荧光定量聚合酶链反应 (FQ PCR)检测宫颈涂片剩余细胞内人乳头瘤病毒 (HPV) 16、18型感染 ,建立快速、灵敏的检测方法的临床意义。方法 :采用FQ PCR技术检测 12 4例异常宫颈细胞和组织标本HPV16、18型感染状况。结果 :细胞学诊断低度鳞状上皮内病变 (LSIL) 4 5例 ,其中FQ PCR检测宫颈细胞标本HPV16、18型DNA阳性14例 (阳性率 31.1% ) ;高度鳞状上皮内病变 (HSIL) 38例 ,HPV16、18型DNA阳性 2 6例 (6 8.4 % ) ;未明确诊断意义的不典型鳞状上皮细胞 (ASCUS) 30例 ,HPV16、18型DNA阳性 10例 (33.3% ) ;鳞状细胞癌 9例 ,HPV16、18型DNA阳性 8例 (88.9% )。组织学检查诊断CINⅠ级 6 7例 ,其中FQ PCR检测活检组织标本HPV16、18型DNA阳性 2 8例 (阳性率 4 1.8% ) ;CINⅡ 14例 ,HPV16、18型DNA阳性 9例 (6 4 .3% ) ;CINⅢ级 11例 ,HPV16、18型DNA阳性 8例 (72 .7% ) ;鳞状细胞癌 2 3例 ,HPV16、18型DNA阳性 17例 (73.9% )。细胞和活检组织两种标本检出的HPV16、18型DNA阳性率差异无显著性 (χ2=1.5 4 ,P >0 .0 5 )。结论 :FQ PCR方法检测宫颈细胞标本HPV16、18型感染 ,具有快速、简便、灵敏度高、特异性强等优点 。

Objective: To establish a rapid and sensitive method to detect cervical human papillomavirus type 16、18 infections in cervical cytological specimens. Methods: HPV type 16、18 DNA were detected in 124 cervical cytological and biopsy specimens by Real-time fluorescence quantitative PCR (FQ-PCR) assay. Results: In cytological specimens of 45 LSIL, 14 cases were positive HPV type 16 and 18 DNA (31.1%);26 cases were positive HPV type 16、18 DNA in 38 HSIL cytological specimens(68.4%); Among 30 ASCUS specimens, 10 cases were positive HPV type 16、18 DNA (33.3%); for the other 9 cervical squamous cell carcinomas specimens, 8 cases were HPV 16、18 DNA positve(88.9%). For biopsy specimens: 28 cases were HPV 16、18 DNA positive out of 67 cervical intraepithelial neoplasia(CIN) I specimens(41.8%); 9 cases positive out of 14 CIN II specimens(64.3% ); for CIN III , there were 8 cases HPV 16、18 DNA positive (72.7%) among 11 speciemens; among 23 cervicl squamous cell carcinomas, 17 cases were HPV type 16、18 DNA positive. And there was no significant difference between cervical cytological and biopsy specimens. Conclusions: FQ-PCR is a rapid, easy, sensitive and special assay to detect HPV type 16、18 infections with cervical cytological specimens, it can be applied for large-scale screening and clinical diagnosis.