中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2013年
3期
212-214
,共3页
朱军%林颖%阮海波%张霞晖%杨倩
硃軍%林穎%阮海波%張霞暉%楊倩
주군%림영%원해파%장하휘%양천
宫颈疾病%乳头状瘤病毒,人%杂交
宮頸疾病%乳頭狀瘤病毒,人%雜交
궁경질병%유두상류병독,인%잡교
Cervix diseases%Papilloma virus,human%Hybridization
目的 分析宫颈病变患者中高危型HPV的感染情况及特点,探讨HR-HPV DNA检测用于高级别宫颈上皮内瘤变中的价值.方法 回顾性分析采用液基薄层细胞学(TCT)检查、HR-HPV检测和阴道镜检查并行活检的官颈病变患者1130例临床资料.经病理组织学检查证实宫颈炎症448例,官颈上皮内瘤变Ⅰ级和(或)湿疣(CIN Ⅰ/HPV Ⅰ)212例,高级别官颈上皮内瘤变或官颈上皮内瘤变Ⅱ/Ⅲ级(C1NⅡ/Ⅲ)442例,宫颈浸润癌(均为鳞癌)28例.结果 1130例官颈病变患者中HR-HPV阳性率为65.84％(744/1130).细胞学异常者为862例,其中ASCUS356例、ASCH 84例、LSIL 216例、HSIL 184例、癌22例.病理学≥CINI/HPVI者682例,HR-HPV阳性率为78.59％(536/682).筛查≥CINⅡ病变TCT的灵敏度为88.94％,特异度为32.73％,阳性预测值为48.49％,阴性预测值为80.60％；HC-Ⅱ的灵敏度为90.21％,特异度为51.82％,阳性预测值为57.14％,阴性预测值为88.14％；两者联合的灵敏度为97.45％,特异度为22.42％,阳性预测值为47.22％,阴性预测值为92.50％.结论 HR-HPV在各年龄组宫颈病变患者中均有较高的感染率,随着宫颈病变程度的加深,HR-HPV的感染率逐步升高.HC-Ⅱ检测HR-HPV DNA是筛查宫颈上皮内瘤变可选用的方法.HR-HPV DNA检测是一种有效的ASCUS和LSIL的管理手段,有较高的灵敏度和阴性预测值.
目的 分析宮頸病變患者中高危型HPV的感染情況及特點,探討HR-HPV DNA檢測用于高級彆宮頸上皮內瘤變中的價值.方法 迴顧性分析採用液基薄層細胞學(TCT)檢查、HR-HPV檢測和陰道鏡檢查併行活檢的官頸病變患者1130例臨床資料.經病理組織學檢查證實宮頸炎癥448例,官頸上皮內瘤變Ⅰ級和(或)濕疣(CIN Ⅰ/HPV Ⅰ)212例,高級彆官頸上皮內瘤變或官頸上皮內瘤變Ⅱ/Ⅲ級(C1NⅡ/Ⅲ)442例,宮頸浸潤癌(均為鱗癌)28例.結果 1130例官頸病變患者中HR-HPV暘性率為65.84％(744/1130).細胞學異常者為862例,其中ASCUS356例、ASCH 84例、LSIL 216例、HSIL 184例、癌22例.病理學≥CINI/HPVI者682例,HR-HPV暘性率為78.59％(536/682).篩查≥CINⅡ病變TCT的靈敏度為88.94％,特異度為32.73％,暘性預測值為48.49％,陰性預測值為80.60％；HC-Ⅱ的靈敏度為90.21％,特異度為51.82％,暘性預測值為57.14％,陰性預測值為88.14％；兩者聯閤的靈敏度為97.45％,特異度為22.42％,暘性預測值為47.22％,陰性預測值為92.50％.結論 HR-HPV在各年齡組宮頸病變患者中均有較高的感染率,隨著宮頸病變程度的加深,HR-HPV的感染率逐步升高.HC-Ⅱ檢測HR-HPV DNA是篩查宮頸上皮內瘤變可選用的方法.HR-HPV DNA檢測是一種有效的ASCUS和LSIL的管理手段,有較高的靈敏度和陰性預測值.
목적 분석궁경병변환자중고위형HPV적감염정황급특점,탐토HR-HPV DNA검측용우고급별궁경상피내류변중적개치.방법 회고성분석채용액기박층세포학(TCT)검사、HR-HPV검측화음도경검사병행활검적관경병변환자1130례림상자료.경병리조직학검사증실궁경염증448례,관경상피내류변Ⅰ급화(혹)습우(CIN Ⅰ/HPV Ⅰ)212례,고급별관경상피내류변혹관경상피내류변Ⅱ/Ⅲ급(C1NⅡ/Ⅲ)442례,궁경침윤암(균위린암)28례.결과 1130례관경병변환자중HR-HPV양성솔위65.84％(744/1130).세포학이상자위862례,기중ASCUS356례、ASCH 84례、LSIL 216례、HSIL 184례、암22례.병이학≥CINI/HPVI자682례,HR-HPV양성솔위78.59％(536/682).사사≥CINⅡ병변TCT적령민도위88.94％,특이도위32.73％,양성예측치위48.49％,음성예측치위80.60％；HC-Ⅱ적령민도위90.21％,특이도위51.82％,양성예측치위57.14％,음성예측치위88.14％；량자연합적령민도위97.45％,특이도위22.42％,양성예측치위47.22％,음성예측치위92.50％.결론 HR-HPV재각년령조궁경병변환자중균유교고적감염솔,수착궁경병변정도적가심,HR-HPV적감염솔축보승고.HC-Ⅱ검측HR-HPV DNA시사사궁경상피내류변가선용적방법.HR-HPV DNA검측시일충유효적ASCUS화LSIL적관리수단,유교고적령민도화음성예측치.
Objective To analyse the infection of high-risk human papiliomavirus(HR-HPV) in cervical lesion wome,and evaluate the significance of high-risk human pappilomavirus detection by hybrid capture Ⅱ (HV-Ⅱ) in screening and diagnosing cervical lesion,especially high grade cervical intraepithelial neoplasia(CIN).Methods A series of 1130 patients of cervical lesion were preliminarily diagnosed by cervical cytological examination,HR-HPV detection by HC-Ⅱ,colposcopy and biopsy under the colposcopy between June 2009 and December 2008,including 212 CIN Ⅰ and(or)condyloma(CIN Ⅰ/HPV Ⅰ),442 CIN Ⅱ/Ⅲ,28 invasive cervical cancer.cervical cytological examination is by thin prep liquid-based cytology test(TCT),and HR-HPV detection is by HC-Ⅱ.Results In 1130 cases the positive of HR-HPV was 65.84％ (744/1130).Unusual cytology result were 862 cases,with 356 ASCUS,84 ASCH,216 LSIL,184HSIL and 22 cancer.The number of biopsy ≥ CINI/HPVI was 682,positive rate of HR-HPV was 78.59％ (536/682).In screening CIN Ⅱ or above,sensitivity,specificity,PPV and NPV of TCT were 88.94％,32.73％,48.49％,80.60％,ofHR-HPV DNA detectiort by HC-Ⅱ were 90.21％,51.82％,57.14％,88.14％,and of HR-HPV detection combined with cytology were 97.45％,22.42％,47.22％,92.50％.Conclusion The infection rate of HR-HPV in cervical lesions is higher in each age group.Infection rate of HR-HPV is ascending with serious degree of cervical lesion.HR-HPV detection by HC-Ⅱ is an important method in screening cervical lesion.HR-HPV detection is a viable option in the management of women with ASCUS and LSIL of TCT,with higher sensitivity and NPV.
