人乳头瘤病毒检测阳性者宫颈黏膜病理表现分析

目的探讨人乳头瘤病毒（HPV）基因亚型检测,在宫颈病变筛查中的意义。方法选择2008年7月1日至12月31日,在台州医院宫颈疾病门诊要求进行宫颈病变筛查的病人,检测HPV-DNA21种亚型。对检测阳性者,常规行阴道镜检查与宫颈活检。结果 3300例病人中,筛查出HPV阳性者990例,阳性率30%,高危型61.8%（612/990）,低危型28.9%（286/990）,未确定型9.3%（92/990）。990例HPV-DNA阳性者行宫颈活检报告：湿疣样改变39.4%（390/990）,慢性宫颈炎21.6%（214/990）,宫颈上皮内瘤变（CIN）Ⅰ级18.8%（186/990）,CINⅡ13.1%（130/990）,CINⅢ4.7%（46/990））,宫颈癌2.4%（24/990）。结论高危型HPV持续感染与宫颈病变密切相关,高危型HPV检测可进一步浓缩高风险人群,使筛查更加有针对性,而感染HPV不等同于患宫颈癌。

Pathological analysis of human papilloma virus in detecting cervical leision screening

Objective To investigate the significance of the human papilloma virus （HPV） types detected in cervical leision screening.Methods The cervical specimens from 3300 female outpatients who received cervical cancer screening in Taizhou hospital,Zhejiang during July 2008 to December 2009 were selected for 21 genotypes HPV detecting by HybriMax,the positive HPV of the patients received colposcopy with multiple biopsy. Results The HPV positive rate was 30% （990/3300）. Among the HPV positive groups,the high-risk type was 61.8%,（612/990）,the low-risk type was 28.9% （286/990）,none definite type was 9.3% （92/990）. According to the pathological diagnosis,the patients were divided into six groups：1. condyloma acuminata 39.4% （390/990）,2. chronic cervicitis 21.6% （214/990）,3. cervical intraepithelial neoplasiaⅠ18.8% （186/990）,4. cervical intraepithelial neoplasiaⅡ13.1% （130/990）,5 cervical intraepithelial neoplasiaⅢ4.7% （46/990）,6. cervical cancer 2.4% （24/990）. Conclusions The study shows the close relationship between the cervical leision and the persistent HPV infection. The cervical screening may be targeted directly to women with high-risk HPV type,but HPV infection is not equivalent to cervical cancer.