摘要
目的 探讨HPV分型检测在子宫颈病变诊断中的价值.方法 收集2012年7月至2013年2月在天津医科大学总医院妇产科门诊（200例）和武装警察部队后勤学院附属医院妇产科门诊（244例）例受检者（机会筛查方法）的子宫颈脱落细胞,采用核酸分子快速杂交基因分型技术进行HPV分型检测和液基薄层细胞学检查（TCT）,并选取其中132例进行阴道镜下异常转化区定位活检、病理检查.以病理检查结果为最终诊断标准.结果 444例中HPV阳性117例,HPV阳性率为26.4％,单一型病毒感染较为常见.排名前5位的HPV型别依次为HPV16、58、33、18、52型,致病风险排名前5位的依次是HPV16、33、39、52和18型,其中HPV16、33、39型致病风险相同.随着年龄增长,HPV阳性率有升高趋势,但各年龄段的HPV阳性率比较,差异无统计学意义（χ2=0.948,P＞0.05）.多重感染与子宫颈病变程度无明显相关性（r=0.132,P＞0.05）.对于子宫颈上皮内瘤变（GIN）Ⅱ及以上病变者,TCT检测阳性率为90％（44/49）,HPV阳性率为96％（47/49）,两者联合检测的阳性率为98％（48/49;χ2=0.063,P＞0.05）.结论 HPV感染率随年龄增加有上升趋势;多重感染与子宫颈病变程度无相关性;TCT与HPV检测具有良好的一致性,两者联合检测可提高检测高级别子宫颈病变的敏感性.
Objective To Investigate the value of HPV genotyping in diagnosis of cervical intraepithelial neoplasia（CIN）.Methods From July 2012 to February 2013,200 women from Tianjin Medical University General Hospital and 244 women from Affiliated Hospital of the Chinese People＆#39;s Armed Forces Logistics College were selected to be HPV genotyping test and thin liqid-based cytology test.Consequently,132 samples were performed colposcopy test and cervical biopsy.Results HPV prevalence was 26.4% （117/444） in this study.The infection of one type HPV was more common.The top 5 of HPV types were HPV16,58,33,18,and 52.The top 5 of the risk for CIN Ⅱ and above followed HPV16,33,39,52 and 18.There was no significant difference between age and HPV positive rate （x2 =0.948,P 〉 0.05）.Multiple infection and cervical lesions rank correlation analysis（r =0.132,P 〉0.05）.For CIN Ⅱ and above disease,cytology positive rate was 90% （44/49）,and HPV positive rate was 96% （47/49） cytology combine HPV positive rate was 98% （48/49,x2 =0.063,P 〉 0.05）.Conclusions HPV infection should increasing trends with age.Cytology test and HPV genotyping test had good consistency.The combination of them can improve the sensitivity for high-grade lesions.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2014年第6期446-450,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
乳头状瘤病毒科
宫颈上皮内瘤样病变
宫颈肿瘤
核酸杂交
Papillomaviridae
Cervical intraepithelial neoplasia
Uterine cervical neoplasms
Nucleic acid hybridization
作者简介
通信作者：陈亚琼，Email：chenyq82@hotmail．com
