新一代杂交捕获技术在宫颈癌筛查中的应用

发布时间：2018-05-05 17:49

本文选题：HPV + 宫颈癌　；参考：《现代妇产科进展》2017年05期

【摘要】：目的:了解新一代杂交捕获技术(DH2)在宫颈癌筛查与传统筛查方式的优势比较,探讨HPV16/18分型检测对DH2初筛阳性患者分流管理的临床意义。方法:2013年、2014年、2015年分别对浙江省慈溪市79847例、81702例、61072例妇女采用巴氏涂片的方法进行宫颈癌筛查,在2015年、2016年分别对浙江省慈溪市35657例、59634例妇女使用DH2检测14种高危型HPV的方法进行宫颈癌筛查。以病理诊断作为金标准,分析高危型HPV检测与巴氏涂片在LSIL以上病变的检出率情况。同时对DH2阳性患者进行HPV16/18检测,对照和比较HPV16/18分流策略的检出情况。结果:2013年、2014年、2015年采用巴氏涂片的方法对LSIL以上病变的检出率分别为0.048%、0.105%、0.134%;2015年、2016年使用DH2检测14种高危型HPV的方法对LSIL以上病变的检出率分别为0.415%、0.550%。2015年采用DH2检测14种高危型HPV初筛模式,LSIL以上病变在DH2阳性及在HPV16/18阳性中的占比分别为4.644%、15.370%;2016年采用DH2检测14种高危型HPV初筛及初筛阳性患者HPV16/18分流的模式,LSIL以上病变在DH2阳性及在HPV16/18阳性中的占比分别为6.365%、22.430%。结论:使用DH2检测14种高危型HPV的方法比传统巴氏涂片对LSIL以上病变的检出率更高,DH2可作为宫颈癌初筛的可行方法;DH2初筛及初筛阳性患者HPV16/18分流管理模式对宫颈癌高危人群进行风险分层管理,重点关注HPV16/18阳性人群,可以进一步提高宫颈癌筛查中的LSIL以上病变检出率。
[Abstract]:Objective: to investigate the advantages of new generation hybrid capture technique (DH2) in cervical cancer screening and traditional screening, and to explore the clinical significance of HPV16/18 typing in shunt management of DH2 positive patients. Methods: in 2013, 2014, 2015, 79847 women (81702 women) in Cixi City, Zhejiang Province, were screened for cervical cancer by pasteurized smears. In 2015 and 2016, 35657 women (59 634 women) in Cixi City, Zhejiang Province, were screened for cervical cancer by using DH2 to detect 14 high-risk types of HPV. Using pathological diagnosis as gold standard, the detection rate of high risk HPV and pasteurized smears above LSIL was analyzed. At the same time, HPV16/18 was detected in DH2 positive patients, and the detection of HPV16/18 shunt strategy was compared and compared. Results: in 2013, 2014, 2015, the detection rate of more than LSIL by using pasteurized smears was 0.048 and 0.1050.134 respectively. In 2015, 2016, the detection rate of 14 high-risk types of HPV with DH2 was 0.415 and 0.550.2015 respectively. The detection rate of 14 kinds of LSIL by DH2 in 2015 was 0.415 and 0.550.2015 respectively. The proportion of LSIL-positive lesions in DH2 positive and HPV16/18 positive was 4.64444 and 15.370 in high-risk HPV primary screening model respectively. In 2016, DH2 was used to detect 14 high risk HPV primary sieve patients and HPV16/18 shunt patients with primary sieve and primary sieve positive in DH2 and HPV16/18 positive, respectively, and the proportion of LSIL positive in HPV16/18 was 4.64444 and 15.370.The HPV16/18 shunt pattern of 14 high risk HPV primary screening and primary sieve positive patients was used in 2016. The proportion of sex was 6.365 and 22.430 respectively. Conclusion: compared with the traditional pasteurization smear, the detection rate of 14 high-risk types of HPV by DH2 is higher than that of the traditional pasteurized smears. DH2 can be used as a feasible method for screening cervical cancer and the HPV16/18 shunt management mode in patients with positive primary screening and positive screening. Risk stratification management is carried out in high risk groups. Focusing on HPV16/18 positive population can further improve the detection rate of LSIL above in cervical cancer screening.
【作者单位】：慈溪市妇幼保健院;
【分类号】：R737.33

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