本文選題：高危型人乳頭瘤病毒 + 宮頸癌��； 參考：《檢驗醫(yī)學》2016年06期

【摘要】：目的分析高危型人乳頭瘤病毒(HPV)DNA檢測及宮頸細胞學檢查[薄層液基細胞學檢測(TCT)或液基細胞學檢測(LCT)]在宮頸疾病診斷中的價值,為宮頸疾病篩查的合理應(yīng)用提供依據(jù)。方法收集進行宮頸疾病診治篩查結(jié)果出現(xiàn)陽性的553例患者,分析其高危型HPV DNA、宮頸TCT或LCT及組織病理結(jié)果,并以組織病理結(jié)果為標準分析比較。結(jié)果高危型HPV DNA檢測與宮頸病變相關(guān),用于宮頸癌及癌前病變篩查,其方法敏感性高(94.34%),特異性低(11.06%)。TCT或LCT用于宮頸癌及癌前病變篩查,方法敏感性為62.58%,特異性為72.34%。2種方法敏感性、特異性差異均有統(tǒng)計學意義(P0.05)。高危型HPV DNA檢測病毒載量分析顯示,良性及炎癥改變或疣性改變病毒載量較低,與鱗狀上皮病變病毒載量相比,差異有統(tǒng)計學意義(P0.05),其他病理類型間病毒載量比較,差異無統(tǒng)計學意義(P0.05)。本研究中25歲以下病例,高危型HPV DNA陽性者組織病理沒有低級別宮頸鱗狀上皮病變(LSIL)以上病例。結(jié)論采用高危型HPV DNA檢測進行宮頸疾病篩查,其敏感性高,能夠減少腺癌的漏診。25歲以下者可不進行HPV篩查。應(yīng)用高危HPV DNA檢測進行宮頸疾病診斷應(yīng)結(jié)合TCT或LCT結(jié)果及臨床分析,對檢測陽性者應(yīng)采用病毒分型技術(shù)進一步分流。
[Abstract]:Objective to analyze the value of high risk human papillomavirus (HPV) DNA detection and cervical cytology (TCT or LCT) in the diagnosis of cervical diseases. Methods 553 patients with positive cervical disease diagnosis and treatment were collected and their high-risk HPV DNA, cervical TCT or LCT and histopathological results were analyzed and compared. Results High risk HPV DNA detection was associated with cervical lesions and was used for screening cervical cancer and precancerous lesions. Its sensitivity was 94.34%, and its specificity was low (11.06%) .TCT or LCT was used to screen cervical cancer and precancerous lesions. The sensitivity of the methods was 62.58 and the specificity was 72.34.2. The differences of specificity were statistically significant (P0.05). The viral load analysis of high-risk HPV DNA test showed that the viral load of benign and inflammatory changes or verrucous changes was lower than that of squamous epithelium lesions (P0.05), and the viral load of other pathological types was higher than that of other pathological types. The difference was not statistically significant (P0.05). In this study, there were no low grade cervical squamous epithelium lesions (lsil) in high risk HPV DNA positive patients under 25 years old. Conclusion the high risk HPV DNA test for cervical screening is highly sensitive and can reduce the number of patients under 25 years of age who have missed diagnosis of adenocarcinoma without HPV screening. The diagnosis of cervical diseases with high risk HPV DNA detection should be combined with the results of TCT or LCT and clinical analysis.
【作者單位】： 復旦大學附屬婦產(chǎn)科醫(yī)院檢驗科;上海國際旅行衛(wèi)生保健中心;
【分類號】：R711;R440

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