高度宫颈上皮内瘤变检测高危型HPV的意义

目的:评价检测高危型人乳头瘤病毒(Human Papillomavirus HPV)对筛查高度宫颈上皮内瘤变的价值。方法:以组织学诊断为标准,随机选择780例妇女进行HPV-DNA、液基细胞学检测,评价检测高危型HPV对筛查高度宫颈上皮内瘤变的价值。结果:780例妇女中,HPV感染发生率为21.3%,CINⅡ及以上的检出率(72.5%)高于CINⅠ(23.5%),两者差异有显著性(P<0.05)。26~35、36~45、46~55岁年龄组HPV感染率高于其他年龄组(P<0.05),但3个年龄组之间无差别(P(0.05)。以组织学诊断为标准,以未明确诊断意义的不典型鳞状上皮细胞(AUSCUS)为分界点,HC2、液基细胞学及联合两种方法的灵敏度分别为89%、92%、100%;特异度分别为88.8%、92.1%、83.1%(P<0.05);阳性预测值为20.5%、23.5%、21.1%(P(0.05);阴性预测值为95.8%、96.7%、99.4%(P<0.05)。结论:HPV检测是筛查高度宫颈上皮内瘤变可选用的方法,联合液基细胞学检测有较高的灵敏度和阴性预测值。

The significance of the high risk HPV DNA test for high grade intraepithelial neoplasia screening

Objective:To investigate the value of HPV DNA test (hybrid captureⅡ) for high grade intraepithelial neoplasia.Methods:The HCⅡ test and the liquid based cytology of 780 cases were performed. The results of the two methods were compared to evaluate the efficacy of HCⅡtest for high grade cervical neoplasia screening by the colposcopic biopsies which was taken as standard.Results:The incidence of human papillomaviral infection was 21.3%. The detection rate of HPV in high grade intraepithelial neoplasia(72.5%)was significantly higher than that in low grade intraepithelial neoplasia (23.5%).The higher infection rate was found among women aged 26～55 than the other age groups.No significant difference was found among women aged 26～55.The histology diagnosis was as criteria and atypical squamous cell of undetermined significant (AUCUS) as an borderline, the sensitivity of the HCⅡ, liquid based cytology and the combination of the two methods were respectively 89%,92%,100%, the specificity 88.8%,92.1%, 83.1%, positive predictive value 20.5%,23.5%, 21.1%; negative predictive value 95.8%,96.7%,99.4%.Conclusion:High risk HPV DNA test is good method for screening high grade intraepithelial neoplasia. The combination of high risk HPV DNA test and liquid based cytology can improve sensitivity and negative predictive value.