高危型HPV DNA检测与细胞学检查用于宫颈疾病诊疗筛查的结果分析

发布时间：2018-07-09 15:15

本文选题：高危型人乳头瘤病毒 + 宫颈癌　；参考：《检验医学》2016年06期

【摘要】：目的分析高危型人乳头瘤病毒(HPV)DNA检测及宫颈细胞学检查[薄层液基细胞学检测(TCT)或液基细胞学检测(LCT)]在宫颈疾病诊断中的价值,为宫颈疾病筛查的合理应用提供依据。方法收集进行宫颈疾病诊治筛查结果出现阳性的553例患者,分析其高危型HPV DNA、宫颈TCT或LCT及组织病理结果,并以组织病理结果为标准分析比较。结果高危型HPV DNA检测与宫颈病变相关,用于宫颈癌及癌前病变筛查,其方法敏感性高(94.34%),特异性低(11.06%)。TCT或LCT用于宫颈癌及癌前病变筛查,方法敏感性为62.58%,特异性为72.34%。2种方法敏感性、特异性差异均有统计学意义(P0.05)。高危型HPV DNA检测病毒载量分析显示,良性及炎症改变或疣性改变病毒载量较低,与鳞状上皮病变病毒载量相比,差异有统计学意义(P0.05),其他病理类型间病毒载量比较,差异无统计学意义(P0.05)。本研究中25岁以下病例,高危型HPV DNA阳性者组织病理没有低级别宫颈鳞状上皮病变(LSIL)以上病例。结论采用高危型HPV DNA检测进行宫颈疾病筛查,其敏感性高,能够减少腺癌的漏诊。25岁以下者可不进行HPV筛查。应用高危HPV DNA检测进行宫颈疾病诊断应结合TCT或LCT结果及临床分析,对检测阳性者应采用病毒分型技术进一步分流。
[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.
【作者单位】：复旦大学附属妇产科医院检验科;上海国际旅行卫生保健中心;
【分类号】：R711;R440

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