219例阴道镜拟诊宫颈HPV亚临床感染患者的病理诊断和HPV-DNA检测分析

目的探讨电子阴道镜检查和HPV-DNA检测对宫颈人乳头瘤病毒亚临床感染（SPI）的诊断价值。方法对2000年3月至2008年4月在海南医学院附属医院妇产科门诊经阴道镜检查拟诊宫颈SPI的219例患者行病理检查,同时行HPV6/11、16/18型DNA的检测。结果 219例阴道镜拟诊宫颈SPI患者中,病理确诊为HPV感染209例,阴道镜的诊断符合率为95.4%。HPV-DNA阳性191例,HPV-DNA检测阳性率为87.2%,其中HPV6/11型阳性126例,HPV16/18型阳性62例,混合感染3例。病理诊断为单纯HPV感染患者133例,其中HPV6/11型115例,HPV16/18型18例,而病理诊断为HPV感染合并宫颈上皮内瘤变（CIN）患者58例,其中HPV6/11型11例,HPV16/18型44例,混合感染3例。结论阴道镜检查是一种早期发现宫颈SPI的简便、有效的方法。宫颈单纯HPV感染的主要亚型为HPV6/11型,HPV感染合并CIN的主要亚型为HPV16/18型。

Pathological examination and human papillomavirus DNA testing in 219 suspected patients of cervical subclinical papillomavirus infection diagnosed by colposcopy

Objective To investigate the diagnostic value of the electronic colposcopy and HPV-DNA detection for human cervical subclinical papillomavirus infection(SPI).Methods 219 suspected cervical SPI patients diagnosed by colposcopy from March 2000 to April 2008 at the Affiliated Hospital of Hainan Medical College were underwent pathological examination and DNA testing for types HPV6/11 and 16/18.Results Among 219 suspected cervical SPI patients,209 cases were diagnosed as HPV infection by pathological examination and the concordant rate of colposcopy examination was 95.4%.191 patients were found to be HPV-DNA positive and HPV-DNA positive rate was 87.2%,of which 126 cases were positive for HPV6/11,62 cases for HPV16/18 and 3 cases for mixed infection.133 cases were diagnosed as simplex virus infection by pathological diagnosis,of which 115 cases were type HPV6/11 and 18 cases type HPV16/18 respectively,whereas 58 patients were diagnosed as HPV infection with cervical intraepithelial neoplasia(CIN),including 11 cases with type HPV6 /11,44 cases with type HPV16/18 and 3 cases with mixed infection.Conclusion Colposcopy is a simple,effective method for early detection of cervical SPI.The main HPV subtype was type HPV6/11 in simplex infection while the main HPV subtype was type HPV16/18 in HPV infection with CIN.