蔡锡渠—宫颈癌筛查技术HPV+检测分析.ppt

荧光PCR原理 HPV系列产品 DNA提取 针对男性样本或女性疣体样本（棉拭子样本），先用细胞保存液/生理盐水洗脱，收集沉淀，而后与上述操作一致 PCR试剂配制 按样本数加入所需溶液的对应量，充分混匀再分装 仪器检测通道选择 这是一篇来自 Khan的影响力非常大的文章,追踪了10年发现HPV18亚型,16亚型的比例最高 We have established the superior sensitivity of pooled high-risk HPV (hrHPV) DNA testing compared with cytology in detecting cervical precancer. Now let us look at whether any of the high-risk genotypes are more carcinogenic than the others. In this seminal HPV DNA study by Khan et al., you can see that over a period of 10 years of follow-up, the risk of developing CIN3 or cancer is significantly higher in women with an HPV16 or HPV18 infection at baseline than in those women with infection associated with one of the other 12 high-risk HPV genotypes.  However, it is noteworthy that the incidence rate of HPV18 positive disease was slower to accumulate compared with the HPV16 positive cumulative incidence rate. Given the powerful carcinogenic potential of HPV16 and HPV18 it seems logical to consider whether individual detection of these genotypes could be beneficial for cervical cancer prevention. ? Khan et al. looked at disease over time among women with negative cytology who tested positive for HPV DNA at baseline; colposcopy was performed once abnormal cytology results were observed. While this study demonstrates the higher disease incidence associated with HPV16 and HPV18, it is not a compelling reason to take a woman with a positive HPV16 or HPV18 genotype result immediately to colposcopy. There were no data available to inform physicians about disease outcomes for women managed using this scenario … until ATHENA. 宫颈癌筛查技术— HPV12+2分型检测 一、HPV12+2检测的意义及临床应用 * HPV的型别 目前已发现超过200种型别的人乳头瘤病毒（HPV）。 依据与生殖道肿瘤相关性，将HPV分为： 低危型 常引起外生殖道湿疣等良性病变；6、11、42、43、44等。 高危型 与子宫颈癌及子宫颈上皮内瘤变（CIN2/3）的发生相关；16、18、31、33、35、39、45、51、52、56、58、59、68等。 HPV分型检测的意义（1）预测受检者发病的风险度，确定最佳的治疗时期 Gary M. Clifford et al ; Cancer Epidemiol Biomarker