高危HPV和TCT在宫颈高级别病变诊断与治疗中的作用研究
[Abstract]:Objective To explore the role of HPV typing test and TCT in the diagnosis and treatment of high-grade cervical lesions, to explore whether HPV 52/58 subtype can be used as a referral colposcopy indicator, HPV typing (16/18/52/58) and TCT results can be used as objective indicators to predict the cervical lesion escalation and residual lesions after conization. Methods From January 1, 2010 to April 31, 2016, 249 patients with complete HPV test results and pathological data were enrolled in the gynecological clinic of Tianjin First Central Hospital. The HPV test method was used as a guided hybridization technique. Results 1. The HPV infection rate was 9. HPV infection rate was 0.76%, single high-risk HPV infection rate was 64.65%, multiple high-risk HPV infection rate was 22.49%. The top five high-risk HPV infection groups were HPV 16,58,52,18,33.2.20-30 years old group (97.30%), followed by 41-50 years old group (92.59%).3. CIN I 45 cases, CIN II-III (including carcinoma in situ) 194 cases, cervical invasive carcinoma 2 cases. HPV16/18 infection was higher than low-grade cervical lesion group (X~2=9.001, p0.05); other HR-HPV infection in high-grade cervical lesion group was lower than low-grade cervical lesion group (X~2=6.773, p0.05); HPV52/58 infection in high-grade cervical lesion group was higher than low-grade cervical lesion group (X~2=5.530, p0.05). 4. TCT results were abnormal, postoperative pathological diagnosis was CIN I 45 cases, CIN 0.05. The results of TCT were statistically significant (X~2=30.311, p0.05). 5. The incidence of high-grade cervical lesions in HSIL patients was higher than that in LSIL patients (X~2=18.186, p0.05). HSIL predicted high-grade cervical lesions with sensitivity, specificity, positive predictive value, negative predictive value. Preoperative HPV16/18 infection, HPV52/58 infection, other HR-HPV infection, HPV16/18 cervical high-grade lesion incidence was higher than other HR-HPV infection (X~2 = 5.282, p0.05); HPV52/58 and HPV16/18 and other HR-HPV had no significant difference (X~2 = 0.051, p0.05; X~2 = 3.551, p0.05). The sensitivity, specificity, positive predictive value and negative predictive value were 86.09%, 21.74%, 84.62% and 55.56% respectively. 7. The incidence of positive margin after conization in HSIL patients was higher than that in LSIL patients (X~2=8.129, P 0.01). The sensitivity, specificity, positive predictive value and negative predictive value of HSIL in predicting positive margin after conization were 1. There was no significant difference in the incidence of positive incision margins among the three groups (X~2=1.025, P 0.05). 9. TCT was HSIL, and the incidence of increased pathological grade after conization was higher than that of LSIL (X~2=6.074, P 0.05). HSIL was more sensitive and specific in predicting the increase of pathological grade after conization. There was no significant difference in the incidence of pathological grade increase among the patients with 10.HPV 16/18, HPV 52/58 and other HR-HPV infection (X~2=0.861, p0.05). Conclusion 1. HPV infection rate increased with the increase of cervical lesion grade. 2. HPV infection rate and distribution of infection subtypes. HPV16/18/52/58 infection was the main infection in cervical lesions of different levels in the region; HPV16/18 could be used as a referral colposcopy index, but HPV52/58 could not be used as a referral colposcopy index. 3. HPV infection age distribution had two peaks, 20-30 years old young women HPV infection rate was the highest, 41-50 years old perimenopausal women appeared the second high. The sensitivity and specificity of HSIL in predicting high-grade cervical lesions were superior to that of different types of high-risk HPV infection; the sensitivity of HSIL in predicting positive margins and increased pathological grade after conization was superior to that of different types of high-risk HPV infection. Therefore, more attention should be paid to the results of cervical cytology in the diagnosis and treatment of cervical lesions. Don't be HSIL.
【学位授予单位】:天津医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R737.33
【参考文献】
相关期刊论文 前10条
1 王秋红;杜桂清;邓桂霞;乔婷婷;聂艳绒;马丹琦;;宫颈上皮内瘤变患者活检与锥切术后病理结果比较[J];贵阳医学院学报;2016年02期
2 张靖;高波;康峗;马智静;李启明;;中国女性宫颈人乳头瘤病毒感染型别分布区域性特征的Meta分析[J];中华微生物学和免疫学杂志;2014年12期
3 吴绪峰;曾蓉;高晗;蔡鸿宁;;宫颈锥切术后全子宫切除的CINⅢ患者病灶残留相关因素分析[J];肿瘤防治研究;2014年06期
4 李寿俊;许国章;易波;陈奕;贺天锋;;宫颈癌高危人乳头瘤病毒型别分布的Meta分析[J];浙江预防医学;2014年05期
5 舒焰红;钱德英;吴越;岑坚敏;陈观娣;阳丽;李志刚;;即查即治策略处理宫颈高度鳞状上皮内病变的临床价值[J];实用医学杂志;2013年03期
6 岑尧;张翠英;张雅丽;侯建华;;中国女性人乳头瘤病毒感染状况及高危型别分布的Meta分析[J];癌症进展;2013年01期
7 吴瑾;贾英;唐良萏;;人乳头状瘤病毒检测对宫颈上皮内瘤样病变Ⅱ~Ⅲ LEEP术后切缘阳性的预后评估[J];重庆医科大学学报;2012年07期
8 张东红;林美珊;;人乳头瘤病毒在国人宫颈病变中感染及型别分布特征的Meta分析[J];中国全科医学;2010年12期
9 李霓;代敏;;中国妇女人乳头状瘤病毒感染的多中心横断面研究[J];中华疾病控制杂志;2008年05期
10 樊庆泊,Tay Sun Kuie,沈铿;子宫颈环形电切术在子宫颈上皮内瘤变治疗中的价值[J];中华妇产科杂志;2001年05期
,本文编号:2244700
本文链接:https://www.wllwen.com/yixuelunwen/fuchankeerkelunwen/2244700.html