高危型人乳头瘤病毒检测在宫颈病变治疗后随访中的临床价值

目的探讨高危型人乳头瘤病毒(HR-HPV)的检测在宫颈病变治疗后随访中的临床价值。方法对诊断为宫颈上皮内瘤样变(CIN)或宫颈浸润癌(I-IIa期)且已手术治疗的196例患者行高危型HPV检测及薄层液基细胞学检查(LPT)并进行随访。结果针对不同级别的病变采取不同的手术方式治疗后6、12个月HPV-DNA负荷量均有明显的降低,且HPV有明显的转阴率;术后切缘阳性与阴性组出现病变残留或复发率分别为57.89%、1.27%,差异有统计学意义(P=0.00);术后HR-HPV持续阳性出现病变残留或复发率为38.71%、0.00%,差异有统计学意义(P=0.00);术后出现病变残留或复发者均有HR-HPV持续感染(22/22),而HR-HPV转阴者无1例出现病变残留或复发(0/134)。结论 HR-HPV检测对于判断疗效和监测预后有重要的临床指导意义;不同手术方式对HR-HPV有明显的清除作用,而术后HR-HPV持续阳性为病变残留或复发的高危人群,应严密随访。

The clinical value of the high-risk human papillomavirus detection in cervical lesions follow-up

Objective To explore the clinical value of the high-risk human papillomavirus(HR-HPV) testing in the follow-up of cervical lesions.Methods High-risk type HPV testing and thin layer of liquid and cytology(LPT) was used for following-up in 196 patients,the patients diagnosed as cervical intraepithelial neoplasia(CIN) or early(I-IIa period) cervical cancer accepted surgical treatment.Results With effective treatment HR-HPV load significantly reduced and had obviously HPV turn negative after 6 or 12 month,the CIN and cervical cancer patients had overall HPV turn negative for 87.75% and 90.30% respectively after 12 month.The cut edge positive and negative groups appeared lesions remain or recurrence rates were respectively 57.89% and 1.27% after treatment,there were significance difference between two groups(P<0.05),and the HR-HPV continuous positive or negative appeared lesions remain or recurrence rates were respectively 38.71% and 0%,there was significant difference between two groups(P<0.05).All patents who appeared lesions remain or recurrence are performance for HR-HPV continue infection(22/22),however,patents who had HR-HPV negative no one appeared lesions remain or recurrence.Conclusion The HR-HPV testing for judging curative effect and prognosis has important clinical guidance significance.Different surgical procedures have significant effect for HR-HPV scavenging,and the patents who have HR-HPV continue infection should receive close follow-up.