上海市人乳头瘤病毒感染及病毒分型与宫颈病变的探讨

发布时间：2018-01-24 16:07

本文关键词： 人乳头瘤病毒基因分型液基薄层细胞学检查宫颈癌上海　出处：《第二军医大学学报》2017年12期 　论文类型：期刊论文

【摘要】：目的了解上海地区妇科就诊人群人乳头瘤病毒(human papilloma virus,HPV)分型感染情况,分析HPV分型检测对宫颈疾病的诊断价值,为临床医师合理应用筛查手段提供依据。方法分析2016年在上海交通大学医学院附属同仁医院妇科因各类原因就诊、自愿接受HPV分型检测病例的检测结果,统计分析HPV不同型别感染情况;其中504例因有临床症状或HPV阳性完成了液基薄层细胞学检查(TCT)和阴道镜下组织病理学检查,以病理诊断为宫颈病变诊断的"金标准"分析高危型HPV感染与宫颈病变的关系。结果 HPV分型检测的病例中,HPV总感染率为23.66%(2 998/12 670),其中84.09%(2 521/2 998)感染高危型HPV;高危型HPV总体感染率为19.90%(2 521/12 670),低危型HPV总体感染率为3.76%(477/12 670)。HPV感染者中,单一亚型感染率为71.21%(2 135/2 998),双重感染率为16.94%(508/2 998),其余为2种以上型别感染。低危型HPV感染在各年龄段差异无统计学意义;高危型HPV感染呈低年龄段人群感染率较高的现象(P0.01)。高危型HPV感染中,感染率最高的5种亚型依次为HPV52、16、53、58、51型,低危型感染中前3位感染型别为HPV81、43、42型。随宫颈病变级别的升级,高危型HPV感染率呈升高趋势。HPV分型检测筛查宫颈疾病较TCT更灵敏,阴性预测值更高,其阴性结果对于排除宫颈癌意义较大。宫颈癌病例HPV感染为16、18和52型。结论 HPV分型检测准确性高并能明确基因类型,联合TCT和组织学检查更能有效地筛查宫颈病变细胞,为临床防治宫颈癌提供更可靠的科学依据。HPV分型检测筛查宫颈病变敏感度和阴性预测值高。初次宫颈癌筛查时,HPV分型检测可以替代TCT单独检测或联合TCT。
[Abstract]:Objective to investigate the gynecological outpatients human papilloma virus in Shanghai (human papilloma virus, HPV) type of infection, analysis of HPV genotyping in the diagnosis of cervical disease, provide the basis for the reasonable application of clinician screening. Analysis method of gynecological Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine in 2016 due to various reasons, voluntarily accept the test results of HPV detection of cases, statistical analysis of different types of HPV infection; including 504 cases with clinical symptoms or positive HPV completed the ThinPrep cytology test (TCT) examination and pathological colposcopy, with pathological diagnosis of cervical lesions diagnosed as the "gold standard" analysis of high-risk HPV infection and cervical lesions. The results of HPV genotyping of HPV cases, the total infection rate was 23.66% (2 998/12 670), of which 84.09% (2 521/2 998) high-risk HPV infection of high-risk HPV overall; The infection rate was 19.90% (2 521/12 670), low risk HPV overall infection rate was 3.76% (477/12 670).HPV infection, single subtype infection rate was 71.21% (2 135/2 998), the double infection rate was 16.94% (508/2 998), the rest for more than 2 kinds of infection was not statistically significant in all types. Age differences in low risk HPV infection; high-risk HPV infection is low age the higher infection rate (P0.01). The phenomenon of high-risk HPV infection, the highest infection rate of 5 subtypes were HPV52,16,53,58,51 type, the low risk of infection in the top 3 infection type is HPV81,43,42 type. With the progression of cervical lesions the upgrade of the high-risk HPV infection rate increased.HPV genotyping in cervical disease screening was more sensitive than TCT, the negative predictive value is high, the negative results for the exclusion of cervical cancer is more significant. HPV infection of cervical cancer cases were 16,18 and 52. Conclusion HPV typing detection with high accuracy and clear Gene type, combined with TCT and histological examination is more effective in screening of cervical lesion cells, provide more reliable scientific basis for detection of.HPV in screening of cervical lesions with high sensitivity and negative predictive values for the prevention and treatment of cervical cancer. Cervical cancer screening in the first time, HPV genotyping can replace TCT detection alone or in combination with TCT.

【作者单位】：上海交通大学医学院附属同仁医院妇产科;第二军医大学长征医院妇产科;
【分类号】：R737.33
【正文快照】： [Acad J Sec Mil Med Univ,2017,38(12):1526-1531]宫颈癌是威胁女性健康的主要恶性肿瘤之一,近年来其发病率呈逐年上升趋势,成为仅次于乳腺癌的女性恶性肿瘤。宫颈癌的主要致病因素之一为人乳头瘤病毒(human papilloma virus,HPV)感染。HPV存在多种基因型别,与宫颈癌相关的高

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