發(fā)布時間：2018-06-01 18:35

  本文選題：人乳頭瘤病毒 + 宮頸腫瘤��； 參考：《中華腫瘤防治雜志》2016年03期

【摘要】：目的人乳頭瘤病毒(human papillomavirus,HPV)檢測是國內(nèi)外公認(rèn)的宮頸癌篩查有效方式。近年來,我國研發(fā)了低成本、快速、簡單的HPV檢測方法,為HPV檢測應(yīng)用到人群篩查提供了希望。本研究分析國產(chǎn)HPV雜交捕獲技術(shù)(daltonbio hybrid capture 2,DH2)初篩不分流及DH2初篩HPV16/18分型檢測分流檢出宮頸癌前病變與宮頸癌的情況,評價此種檢測技術(shù)應(yīng)用于農(nóng)村地區(qū)宮頸癌篩查的可行性。方法按整群抽樣的方法,對新密市7個鄉(xiāng)鎮(zhèn)35~64歲的農(nóng)村婦女使用DH2檢測進(jìn)行宮頸癌篩查,陽性者召回做陰道鏡,對鏡下發(fā)現(xiàn)的可疑病變?nèi)』罱M織檢查,病理診斷作為金標(biāo)準(zhǔn),宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia,CIN)≥2級(CIN2+)患者需手術(shù)治療。對DH2陽性者同時進(jìn)行HPV16/18分型檢測,探索DH2初篩和HPV16/18分型檢測分流策略對宮頸疾病的檢出情況。結(jié)果DH2篩查陽性率為12.23%(1 512/12 358),其中≥50歲組HPV感染率和50歲組HPV感染率分別為13.40%(749/5 588)和11.27%(763/6 770),比值比(odds ratio,OR)=1.22(1.09~1.36),差異有統(tǒng)計學(xué)意義,χ~2=12.98,P0.001。共檢出CIN2+87例(0.72%),CIN3+50例(0.41%),達(dá)到新密市近年最高水平。采用HPV16/18分型檢測分流策略的陽性率為2.66%(319/11 981),檢出CIN2+62例(0.52%),CIN3+37例(0.31%)。HPV16/18分流檢出CIN2+占總病例的73.81%(62/84),檢出CIN3+占總病例的77.08%(37/48)。結(jié)論 DH2檢測對宮頸癌前病變及宮頸癌的檢出率較高,可作為宮頸癌篩查方法使用。HPV16/18分流策略雖然可以降低陰道鏡轉(zhuǎn)診率,但是會漏診部分CIN2+患者,漏診患者的基因型別有待進(jìn)一步分析。
[Abstract]:Objective the detection of human papillomavirus (HPV) is an effective method for cervical cancer screening at home and abroad. In recent years, China has developed a low-cost, rapid, simple HPV detection method, which provides hope for the application of HPV detection in population screening. In this study, we analyzed the situation of detecting cervical precancerous lesions and cervical cancer by DH2 HPV16/18 typing, and evaluated the feasibility of applying this technique to cervical cancer screening in rural areas. Methods according to the method of cluster sampling, DH2 was used to screen cervical cancer in rural women aged 35 to 64 years old in 7 towns in Xinmi city. The positive women were recalled to do colposcopy, biopsy was taken from suspicious lesions found under the microscope, and pathological diagnosis was taken as the gold standard. Patients with cervical intraepithelial neoplasia (cervical intraepithelial neoplasms) 鈮，

本文編號：1965214