HPV检测联合TCT在宫颈疾病筛查中的临床意义

目的了解粤东地区不同HPV亚型的分布情况,感染的高峰年龄及阳性者宫颈细胞学改变。方法以2009年11月~2013年7月于汕头市澄海区人民医院体检行高危型HPV检测者为研究对象,对HPV阳性患者行TCT液基细胞学检查。结果该组人群共计3 167人,阳性人数217人,阳性率为6.9%。感染亚型排列分别为52、16、58、53、CP8304、18、31;年龄主要集中在30~39岁,该年龄段的感染率为51.61%,40~49岁年龄段的感染率为31.34%,20~29岁年龄段的感染率为7.37%,50~59岁年龄段的感染率为9.68%;年龄层感染率比例分别为:50~59年龄段感染者占全部感染者的13.46%,40~49岁年龄段感染者占全部感染者的8.9%,30~39岁年龄段感染者占全部感染者的5.94%,20~29岁年龄段感染者占全部感染者的4.84%。阳性者中行TCT细胞学检查者150例,病理结果为WNL(正常范围)108例(27%),ASCUS(意义不明的不典型鳞状上皮细胞)22例(14.57%),LSIL(低度鳞状上皮细胞病变)18例(12%),HSIL(高度鳞状上皮细胞病变)2例(1.33%),SCC(鳞状细胞癌)0例(0%)。结论粤东汕头市澄海区HPV亚型感染分布以52、16型为主,是宫颈病变发生的必要生物学条件,对HPV阳性者应尽量行TCT细胞学检查,提高筛查敏感性,其与癌前病变及宫颈癌具有密切的相关性。

Significance of detection of HPV DNA combined with cytology in screening of cervical cancer

Objective To evaluate the distribution of different papillomavirus（HPV） genotypes in genital tract of Chinese population,the peak age of infection and the change of cervix cytology in those who were HPV positive. Method Women of high risk for HPV infection were enrolled in this investigation and the positives for HPV were further examined by thin prepare liquid based cytology test（TCT）. Results Out of the 3 176 women 217 positives for HPV were detected with total positive rate of 6.9%. The prevalence of subtypes were HPV52, 16, 58, CP8304, 18 and 31, mainly concentrated in the age group of 30~39 with a infection rate of 51.61%. The infection rates in the age group of 40-49 was 31.34%（accounted for 8.9%of the total infections）,7.37% in the age group of 20-29（occupied 4.84% of the total infection） and 9.68% in the age group of50-59（accounted for 13.46% of the total infection）,Totally.150 women positive for HPV received TCT, the pathological findings showed that ：108 cases were in normal range（ WNL）（27%）,22 were ASCUS（14.75%）,18 were LSIL（12%）,2 were HSIL（1.33%）,no squamous cell carcinoma（SCC）. Conclusion The HPV subtypes of 52 and 16 are predominated in Cehnghai district of Shantou city. TCT be performed on the cases positive for HPV to screening the pathological changes of cervix.