高危型HPVDNA检测在宫颈病变筛查中应用价值.docVIP

高危型HPVDNA检测在宫颈病变筛查中应用价值 　　【摘要】目的：探讨高危型人乳头瘤病毒(HR-HPV)检测在宫颈病变筛查中的应用价值。方法：应用第二代杂交捕获法(HC-II)和液基薄层细胞学(TCT)对839例受检者同时行13种高危型HPV DNA检测和宫颈细胞学检查；HPV阳性和细胞学结果为非典型鳞状细胞(ASCUS)及以上患者行阴道镜下病理活检，分析HPV感染与宫颈上皮内病变的关系。结果：HPV检出率随宫颈病变程度加重呈上升趋势，ASCUS中HPV检测阳性率为75.47%，HPV阳性的ASCUS患者中病理活检47.17%为宫颈上皮内瘤变或更严重病变。结论：HPV检测在宫颈病变筛查中可作为细胞学的辅助手段提高诊断准确性，并可指导HPV感染者的治疗及用于患者的追踪随访。 　　【关键词】人乳头瘤病毒；宫颈上皮内病变；筛查 　　文章编号：1009-5519（2007）17-2547-03 中图分类号：R36 文献标识码：A 　　Application value of high-risk HPV-DNA test in cervical lesions screening 　　ZHONG Shou-jun，MI Xian-jun，DUAN Li-feng，et al. 　　（Department of Pathology，Boai Hospital of Zhongshan，Zhongshan 528403，China） 　　【Abstract】Objective：To investigate the application value of high-risk human papilloma virus (HR-HPV) DNA test in cervical lesions screening. Methods：839 cases cytological specimens exfoliated from cervix were tested by both the hybrid capture II (HC-II) assay and the thin prep pap smear fluid-based system (TCT) for detecting 13 types of high-risk HPV DNA. Both patients with positive results of high-risk HPV DNA and pap smear showed atypical squamous cells of undetermined significance (ASCUS) were performed colposcopy and histological examination on the cervical tissue. Results：HPV infection rate increased according to the seriousness degree of cervical lesions. Of the patients with ASCUS and positive results of high-risk HPV DNA，47.17% of patients were found to have cervical intraepithelial neoplasm (CIN). Conclusion：HPV DNA test is very important to improve the diagnostic accuracy. Earlier detection of high-risk HPV types can instruct the treatment and trace the infected patients. 　　【Key words】Human papilloma virus；Cervical lesions；Screening 　　 　　宫颈癌是严重威胁妇女生命健康的恶性肿瘤之一。目前大量的流行病学和分子生物学研究已经证明人乳头瘤病毒(Human Papilloma Virus，HPV)感染是宫颈癌发生的主要危险因素，其中高危型人乳头瘤病毒(HR-HPV)持续感染可引起宫颈上皮内瘤变(cervical intraepithelial neoplasm，CIN)与宫颈癌[1，2]。由于从宫颈CIN发展到宫颈癌是一个较长期的过程，因此对宫颈癌前病变的早期诊断和治疗，可有效地预防宫颈浸润癌的发生，将HPV-DNA检测作为宫颈癌筛查的一种辅助手段已成为当前医学预防和研究的热点之一。总结839例受检者宫颈细胞学及HPV感染情况，以阴道镜下宫颈