国产HPV杂交捕获技术在农村宫颈癌筛查中的应用

发布时间：2018-06-01 18:35

  本文选题：人乳头瘤病毒 + 宫颈肿瘤　； 参考：《中华肿瘤防治杂志》2016年03期

【摘要】：目的人乳头瘤病毒(human papillomavirus,HPV)检测是国内外公认的宫颈癌筛查有效方式。近年来,我国研发了低成本、快速、简单的HPV检测方法,为HPV检测应用到人群筛查提供了希望。本研究分析国产HPV杂交捕获技术(daltonbio hybrid capture 2,DH2)初筛不分流及DH2初筛HPV16/18分型检测分流检出宫颈癌前病变与宫颈癌的情况,评价此种检测技术应用于农村地区宫颈癌筛查的可行性。方法按整群抽样的方法,对新密市7个乡镇35~64岁的农村妇女使用DH2检测进行宫颈癌筛查,阳性者召回做阴道镜,对镜下发现的可疑病变取活组织检查,病理诊断作为金标准,宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)≥2级(CIN2+)患者需手术治疗。对DH2阳性者同时进行HPV16/18分型检测,探索DH2初筛和HPV16/18分型检测分流策略对宫颈疾病的检出情况。结果DH2筛查阳性率为12.23%(1 512/12 358),其中≥50岁组HPV感染率和50岁组HPV感染率分别为13.40%(749/5 588)和11.27%(763/6 770),比值比(odds ratio,OR)=1.22(1.09~1.36),差异有统计学意义,χ~2=12.98,P0.001。共检出CIN2+87例(0.72%),CIN3+50例(0.41%),达到新密市近年最高水平。采用HPV16/18分型检测分流策略的阳性率为2.66%(319/11 981),检出CIN2+62例(0.52%),CIN3+37例(0.31%)。HPV16/18分流检出CIN2+占总病例的73.81%(62/84),检出CIN3+占总病例的77.08%(37/48)。结论 DH2检测对宫颈癌前病变及宫颈癌的检出率较高,可作为宫颈癌筛查方法使用。HPV16/18分流策略虽然可以降低阴道镜转诊率,但是会漏诊部分CIN2+患者,漏诊患者的基因型别有待进一步分析。
[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，

本文编号：1965214