高危型人乳头状瘤病毒检测在子宫颈癌筛查中的意义

目的：探讨高危型人乳头状瘤病毒（HR—HPV）检测在子宫颈癌筛查中的意义。方法：对2442例子宫颈疾病患者进行液基细胞学（TCT）检测，2147例患者进行HPV杂交捕获法二代或核酸分子快速导流杂交技术检测（HPV检测），其中783例患者同时进行TCT和HPV检测。723例因细胞学异常或细胞学正常而HR—HPV检测阳性，或细胞学正常HR-HPV阴性临床高度怀疑病变的患者行阴道镜下多点活检、宫颈电圈切除术（LEEP），结合病理结果进行分析。结果：TCT联合HPV检测的样本中，TCT正常或炎症、不能明确意义的非典型鳞状上皮细胞（不除外高度病变非典型鳞状上皮细胞5例，合并计算）、低度鳞状上皮内瘤变、高度鳞状上皮内瘤变的HR—HPV阳性率分别为22．39％、48．09％、74．47％和88．46％，差异有统计学意义（P〈0．01）；随着细胞学诊断级别的升高，HR—HPV阳性率显著上升。阴道镜下多点活检、LEEP病理结果：正常或炎症组、宫颈上皮内瘤变（CIN）1、CIN2、CIN3、鳞状细胞癌和湿疣中HR—HPV阳性率分别为23．72％、83．87％、85．19％、88．10％、92．86％、72．37％，差异有统计学意义（P〈0．01）。结论：持续的HR—HPV阳性与宫颈病变的演进有关，HR—HPV检测在子宫颈癌筛查中具有重要意义。

The significance of high-risk human papilloma virus detection in cervical cancer screening

Objective： To explore the significance of high-risk human papilloma virus （HR-HPV） detection in cervical cancer screening . Methods ：Two thousand four hundred and forty-two patients were detected using liquid base cytology（TCT） ,2 147 patients were detected by HPV hybrid capture method of the second generation （ HPV-HC lI ） or nucleic acid molecular hybridization technique,TCT and HPV testing of which 783 patients were simultaneously detected. HR-HPV testing in 723 cases with normal or abnormal cytology were positive, the patients with normal cytology, negative HR-HPV and clinical highly suspected lesions were treated with muhipoint biopsy under colposcope and cervical electric ring resection （LEEP）, these data combined with pathological results were analyzed. Results： Amony samples with TCT and HPV testing, the HR-HPV positive rates in normal or inflammation TCT, ASC-US, low- grade squamous intraepithelial lesion and high-grade squmous intraepithelial lesion were 22.39% ,48.09%, 74.47% and 88.46% , respectively, the difference of which was statistical significance （P 〈 0.01 ）. The HR-HPV positive rate increased significantly with the increasimg of cytology diagnosis level. LEEP pathological results showed the HR-HP~ positive rates in normal or inflammation tissue, cervical intraepithelial neoplasia（CIN） 1, CIN 2, CIN 3, squamous cell carcinoma and condyloma were 23.72%, 83.87% , 85.19% , 88.10%, 92.86% and 72. 37%, respectively, the difference of which was statistical significant （ P 〈 0. 01 ）. Conclusions： The continuous HR-HPV positive is related to the evolution of cervical lesions, the HR-HPV detection has important significant in screening cervical cancer.