摘要
目的探讨核酸扩增荧光检测(real-timePCR)方法在筛查宫颈癌及其癌前病变中的临床应用价值。方法对2008年7月至2009年4月在中日友好医院妇产科就诊的948例妇女进行宫颈细胞学检测、杂交捕获二代(HCⅡ)和real-timePCR两种高危型人乳头瘤病毒(HPV)检测。对其中液基细胞学(LCT)、HCⅡ和real-timePCR3种检测任一或一个以上结果异常者进行组织病理学检查。结果 948例妇女中有870例妇女两种HPV检测结果一致,总体符合率达91.77%,一致性检验Kappa值=0.789;两者之间具有极好的一致性。在对高级别宫颈上皮内瘤变(CIN)的检测中LCT、HCⅡ和real-timePCR的敏感性分别为90.98%、95.08%和94.26%,阴性预测值分别为98.37%、99.10%和98.97%。结论 real-timePCR与HCⅡ检测具有很好的一致性,可用于临床宫颈癌及其癌前病变的筛查;联合LCT和高危型HPV检测可明显提高宫颈癌前病变和宫颈癌的检出率。
Objective To investigate the clinical application value of real-time fluorescent PCR to detect cervical intraepithelial neoplasia 2 （CIN2） and severe cervialdiseases. Methods High risk HPV （ HR HPV） DNA detections were done by HC ]I and real-time PCR with 948 women cytological samples in China-Japan Friendship Hospital from Jul. 2008 to Apr. 2009, at the same time, these women accepted liquid-based cytological test. For the patients with the abnormal cytological results or positive HR-HPV DNA, biopsy were done under colposcope. Results Concordant results of the two HR HPV DNA detection methods were found in 870 cervical samples （ overall agreement, 91.77% ; Cohen＇s Kappa = 0. 789）. For the detection of CIN2, the sensitivity of LCT,HC Ⅱ and real-time PCR were 90. 98% ,95.08% and 94. 26%, and the negative predictive value were 98.37% ,99. 10% and 98. 97%. Conclusion Real-time PCR has good accordance with HC Ⅱ for HR HPV detection and can been used in clinical cervical cancer screening. LCT combined with HR-HPV testing raised the sensitivity of screening of cervical cancer and precancerous lesions greatly.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2010年第5期365-367,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
人乳头瘤病毒
宫颈肿瘤
核酸杂交
阴道涂片
human papillomavirus
cervix neoplasms
nucleic acid hybridization
vaginal smears
作者简介
通讯作者：卞美璐，电子信箱．bianmeilu@hotmail．com
