医学检验与临床
醫學檢驗與臨床
의학검험여림상
MEDICAL LATORATORY SCIENCE AND CLINICES
2014年
2期
32-34,39
,共4页
卜祥茂%徐莉莉%陈艳萍%宋卫青
蔔祥茂%徐莉莉%陳豔萍%宋衛青
복상무%서리리%진염평%송위청
HPV分型检测%液基细胞学检查%宫颈病变
HPV分型檢測%液基細胞學檢查%宮頸病變
HPV분형검측%액기세포학검사%궁경병변
HPV genotype detection%TCT%Cervical lesions
目的：探讨人乳头瘤病毒(HPV)分型检测和液基细胞学(TCT)检查在筛查宫颈病变中的应用。方法：回顾性分析2012.9~2013.9在我院妇科门诊就诊,同时采用HPV分型和TCT检查的门诊妇女宫颈脱落细胞标本1128例,并最终进行组织病理学检查。结果：1128例标本中HPV阳性率为64.4%(726/1128)，共检出21种亚型，高危亚型16种，低危亚型5种，高危型以16,58,52多见，构成比分别为25.0%，12.1%和10.2%。低危型以61,11型多见，构成比分别为3.4%和1.9%。其中单一感染555例，多重感染171例，最多为四重感染。TCT检查≥ASCUS为87.8%（990/1128），在ASCUS、LSIL、HSIL和SCC中HPV的检出率分别为60.3%、71.8%、80.3%和100%。HPV分型检测(H组)的阳性预测值为74.1%，阴性预测值为68.7%，TCT检查(T组)的阳性预测值和阴性预测值分别为63.2%（626/990）和72.5%（100/138），两者联合检测(H+T组)阳性预测值和阴性预测值分别为75.5%（100/138）、100%（100/100）。H组和H+T组的阳性预测值高于T组(X2值分别为22.690，28.822，P值均为0.000)，H+T组的阴性预测值高于H组和T组（X2值41.847,32.768，P值均为0.000）。结论： HPV分型检测是准确性高并能明确基因类型及多重感染的检测，联合TCT检查更能有效的筛查宫颈病变细胞，为临床防治宫颈癌及青岛地区HPV疫苗使用提供更可靠地科学依据。
目的：探討人乳頭瘤病毒(HPV)分型檢測和液基細胞學(TCT)檢查在篩查宮頸病變中的應用。方法：迴顧性分析2012.9~2013.9在我院婦科門診就診,同時採用HPV分型和TCT檢查的門診婦女宮頸脫落細胞標本1128例,併最終進行組織病理學檢查。結果：1128例標本中HPV暘性率為64.4%(726/1128)，共檢齣21種亞型，高危亞型16種，低危亞型5種，高危型以16,58,52多見，構成比分彆為25.0%，12.1%和10.2%。低危型以61,11型多見，構成比分彆為3.4%和1.9%。其中單一感染555例，多重感染171例，最多為四重感染。TCT檢查≥ASCUS為87.8%（990/1128），在ASCUS、LSIL、HSIL和SCC中HPV的檢齣率分彆為60.3%、71.8%、80.3%和100%。HPV分型檢測(H組)的暘性預測值為74.1%，陰性預測值為68.7%，TCT檢查(T組)的暘性預測值和陰性預測值分彆為63.2%（626/990）和72.5%（100/138），兩者聯閤檢測(H+T組)暘性預測值和陰性預測值分彆為75.5%（100/138）、100%（100/100）。H組和H+T組的暘性預測值高于T組(X2值分彆為22.690，28.822，P值均為0.000)，H+T組的陰性預測值高于H組和T組（X2值41.847,32.768，P值均為0.000）。結論： HPV分型檢測是準確性高併能明確基因類型及多重感染的檢測，聯閤TCT檢查更能有效的篩查宮頸病變細胞，為臨床防治宮頸癌及青島地區HPV疫苗使用提供更可靠地科學依據。
목적：탐토인유두류병독(HPV)분형검측화액기세포학(TCT)검사재사사궁경병변중적응용。방법：회고성분석2012.9~2013.9재아원부과문진취진,동시채용HPV분형화TCT검사적문진부녀궁경탈락세포표본1128례,병최종진행조직병이학검사。결과：1128례표본중HPV양성솔위64.4%(726/1128)，공검출21충아형，고위아형16충，저위아형5충，고위형이16,58,52다견，구성비분별위25.0%，12.1%화10.2%。저위형이61,11형다견，구성비분별위3.4%화1.9%。기중단일감염555례，다중감염171례，최다위사중감염。TCT검사≥ASCUS위87.8%（990/1128），재ASCUS、LSIL、HSIL화SCC중HPV적검출솔분별위60.3%、71.8%、80.3%화100%。HPV분형검측(H조)적양성예측치위74.1%，음성예측치위68.7%，TCT검사(T조)적양성예측치화음성예측치분별위63.2%（626/990）화72.5%（100/138），량자연합검측(H+T조)양성예측치화음성예측치분별위75.5%（100/138）、100%（100/100）。H조화H+T조적양성예측치고우T조(X2치분별위22.690，28.822，P치균위0.000)，H+T조적음성예측치고우H조화T조（X2치41.847,32.768，P치균위0.000）。결론： HPV분형검측시준학성고병능명학기인류형급다중감염적검측，연합TCT검사경능유효적사사궁경병변세포，위림상방치궁경암급청도지구HPV역묘사용제공경가고지과학의거。
Objective:To evaluate the role of human papillomavirus(HPV) genotyping detection and thinprep cytology test(TCT )for screening cervical lesions.Methods:A retrospective analysis 1128 cases of cervical cytology specimens from September 2012 to September 2013 using HPV、TCT and cervical biopsy.Results: In 1128 cases of specimens, the positive rate for HPV infection was 64.4%(726/1128) and there were 21 kinds of genotypes, high-risk subtype 16 kinds, low-risk types 5 kinds. High-risk subtype infection were 16 (25.0%), 58 (12.1%), 52(10.2%) and low-risk subtype main was HPV 61(3.4%), 11(1.9%). Single subtype was detected in 555 cases,double or multiple 171 cases, and quadruple infection was also can be detected. TCT ≥ASC-US was 87.8%(990/1128). In ASCUS, LSIL, HSIL and SCC, the detection rates of HPV infection were 60.3 %, 71.8%, 80.3%,100 % respectively. The positive predict value (PPV) of HPV genotype detection was 74.1% and negative predict value(NPV) was 68.7%. The PPV and NPV of TCT were 63.2% and 72.5%, and HPV joint TCT were 75.5% and 100%. The PPV of group H and group H+T was higher than that of group T. The NPV of group H+T were higher than that of group H and group T.Conclusions:The genotyping technology for detection HPV has very high accuracy, joint TCT screen diseased cells effectively in cervical lesions, and can provide more reliable scientific basis for the prevention and treatment of cervical cancer and for the use of HPV vaccine in Qingdao.
