基质辅助激光解吸电离飞行时间质谱和HPV基因测序分型检测阴道自取样本用于子宫颈癌筛查的有效性研究

发布时间：2018-04-21 15:08

本文选题：阴道自取样本 + 激光辅助解析/飞行时间质谱技术　；参考：《中国妇产科临床杂志》2017年02期

【摘要】：目的评价不同保存形式的阴道自取样本联合激光辅助解析/飞行时间质谱技术(MALDI-TOF)和HPV基因测序分型检测技术(SEQ HPV)用于宫颈癌筛查的有效性。方法 319例研究对象来自北京大学深圳医院门诊和子宫颈癌筛查项目中因异常宫颈细胞学和(或)高危型HPV阳性者需行阴道镜检查的妇女。采集液体载体、FTA固体卡和POI固体卡三种形式的阴道自取样本三份和医取样本一份。四种样本分别行PCR法(Cobas 4800)、MALDI-TOF和SEQ HPV法高危型HPV检测。结果 (1)MALDI-TOF检测阴道自取样本与Cobas4800检测医取样本比较,高危型HPV的一致率:液体载体88.58%,FTA卡83.04%,POI卡87.89%;对应的HPV16/18的一致率为97.58%、93.77%和97.23%;检测CIN2及以上病变(CIN2+)的敏感度为93.44%、88.52%和95.08%。(2)SEQ HPV检测阴道自取样本与Cobas 4800检测医取样本比较,高危型HPV的一致性:液体载体89.62%,FTA卡86.85%,POI卡89.97%,对应的HPV16/18的一致为97.23%、95.50%和97.23%;检测CIN2+的敏感度为96.72%、93.44%和96.72%,两者比较,差异无统计学意义(P0.05)。结论与Cobas 4800检测医生取宫颈细胞样本比较,MALDI-TOF和SEQ HPV两种方法用于自取阴道宫颈脱落细胞样本高危型HPV的检测一致性较高;对于高级别宫颈病变,其筛查灵敏度无显著差别。
[Abstract]:Objective to evaluate the effectiveness of different preserved forms of vaginal samples combined with laser assisted analysis / time of flight mass spectrometry (MALDI-TOF) and HPV sequencing typing for cervical cancer screening. Methods 319 women with abnormal cervical cytology and / or high risk HPV positive in outpatient clinic and cervical cancer screening project of Shenzhen Hospital of Peking University were examined by colposcopy. Three vaginal samples and one medical sample were collected from three types of liquid carrier: FTA solid card and POI solid card. Four kinds of samples were detected by PCR and SEQ HPV respectively. Results A comparison was made between MALDI-TOF and Cobas4800. The consistency rate of high risk HPV: 87.89% for liquid carrier 88.58% and 83.04% for HPV16/18; 97.58% and 97.23% for HPV16/18; the sensitivity for detecting CIN2 and above was 93.4444% and 88.52%; and the sensitivity of 95.08%.(2)SEQ HPV for vaginal self-sampling was compared with that for Cobas 4800. The consistency of high risk type HPV: the liquid carrier 89.62% and 86.85%; the corresponding HPV16/18 was 97.2395.50% and 97.23%; the sensitivity of detecting CIN2 was 96.72% 93.44% and 96.72% respectively. There was no significant difference between the two groups (P 0.05). Conclusion compared with Cobas 4800, the two methods, MALDI-TOF and SEQ HPV, are more consistent in the detection of high risk type HPV from vaginal cervical exfoliated cells, but there is no significant difference in screening sensitivity for high grade cervical lesions.
【作者单位】：北京大学深圳医院妇产科深圳市女性重大疾病早期诊断技术重点实验室;
【基金】：深圳市科创委(GCZX2015043016200372、JCYJ20140415162338808、JCYJ20140415162338821)
【分类号】：R737.33

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