高危型HPV检测在宫颈病变随访中的价值_医学论文.docVIP

高危型HPV检测在宫颈病变随访中的价值_医学论文 高危型HPV检测在宫颈病变随访中的价值_医学论文 作者：初慧君 戴淑真 刘丽芝 车艳辞 李明霞 【摘要】 目的探讨高危型人乳头瘤病毒(HR-HPV)检测在宫颈癌及其癌前病变随访中的临床意义。方法采用HPV-DNA检测(HC-2)、薄层液基细胞学检查(LCT)对术后组织病理学确诊为宫颈癌及其癌前病变的174例病人进行追踪随访。结果经规范治疗后随访过程中,术后1、3、10与22月HR-HPV-DNA检测预测病变残留或复发的阳性预测值分别为23.9% 30.8%、55.2%与45.7%，阴性预测值均为100%。宫颈锥切组1、3、10及 22月HPV阴性率分别为65.0%、68.9%、87.2%与86.7%全子宫切除组1、3、10及 22月HPV阴性率分别为63.2%、70.6%、75.0%与79.4%广泛子宫切除组1、3、10及 22月HPV阴性率分别为53.0%、71.0%、80.0%与67.0%。结论HR-HPV-DNA检测在宫颈癌及宫颈上皮内瘤变治疗后随访中起重要作用。针对不同级别病变采用的手术方式均可有效清除HPV感染，但其转阴需要一定时间。治疗后HR-HPV仍阳性者应及时进行干预，以减少病变复发。 【关键词】 人乳头瘤病毒宫颈肿瘤随访研究 　[ABSTRACT]ObjectiveTo approach the clinical significance of the high-risk human papillomavirus (HR-HPV) in the follow-up of cervical cancer and precancerous lesions.MethodsFollow-up using HPV-DNA testing (HC-2) and thin-layer liquid-based cytology (LCT) on 174 patients,whose postoperative histological diagnosis was cervical cancer or precancerous lesion.ResultsWith standard treatment, After 1 month,3 months,10 months,22 months of follow-up, HR-HPV-DNA test results can predict residual or recurrent lesions, and it’s positive predictive value was 23.9%, 30.8%, 55.2%, 45.7%, respectivelythe negative predictive values were all 100%. After 1 month,3 months,10 months,22 months of follow-up, HPV-negative rates of the patients who had cervical conization were 65.0%,68.9%,87.2%,86.7%,respectivelythe rates of the patients who had hysterectomy were 63.2%,70.6%,75.0%,79.4%and the rates of the patiens who had radical hysterectomy were 53.0%,71.0%,80.0%,67.0%.ConclusionHR-HPV-DNA detection plays an important role in cervical cancer and cervical intraepithelial neoplasia’s follow-up. The surgical modes for different levels of disease can removal HPV infection effectively. However,it perhaps takes some time. After treatment,the HR-HPV-positive patients should been intervened in oder to reduse the residue or recurrence. 　　[KEY WORDS]human papillomavirus uterine cervical neoplasms follow-up studies 　　目前根据我国国情，预防宫颈癌最有力的措施是消灭宫颈上皮内瘤样变(C