高危型人乳头瘤病毒检测评价宫颈上皮内瘤变宫颈锥切术疗效的意义

目的:探讨宫颈上皮内瘤变(CIN)治疗后高危型人乳头瘤病毒(HR-HPV)清除情况,评价HR-HPV检测在预测病变残留或复发中的意义.方法:对2008年10月01日至2009年12月30日在新疆自治区人民医院用第二代杂交捕获( HC2)法检测HR-HPV阳性,在阴道镜下活检诊断为CIN的90例患者进行宫颈锥切术,术后6,12,18,24个月分别行HR-HPV(检测).对HR- HPV检测在预测病变残留或复发的价值进行回顾性分析.结果:CIN治疗后HR-HPV持续阳性人群病变残留或复发率达39.3％.HR-HPV阳性组与阴性组复发或残留有统计学意义(P＜0.001).HPV在预测锥切术后残留或复发的敏感性为100％,特异性为78.20％,阳性预测值为41.37％,阴性预测值为100％.结论:术后HR-HPV持续阳性提示病变残留或复发的可能性.对于术后HPV持续阳性者宜严密随访.

Predictive Value of High Risk HPV Detection in Cervical Intraepithelial Neoplasm After Conization of Cervix

Objective: To approach the relationship of high risk(HR)-HPV detection and the outcomes of cervical intraepithelial neoplasm(CIN) after conization of cervix.Methods: A retrospective study was conducted on 90 women who underwent LEEP or CKC for CIN.HR-HPV positive hybrid captureⅡ method was used in all patients to detect viral load of HR-HPV respectively 6,12,18,24 months after treatment.Results: The residua or recurrence rate rate after conization among those HR-HPV persistent positive was 39.3%,and there was a significant difference in residua or recurrence between HR-HPV positive group and negative group after conization(P<0.001).The sensitivity,specificity,positive predictive value,and negative predictive value of high risk HPV-DNA test for the diagnosis of residual/recurrent was respectively 100%,78.20%,41.37%,and 100%.Conclusion: HPV infection after treatment suggests persistence or recurrence of the disease,and need to be followed closely.