人乳头瘤病毒检测在宫颈病变中的应用价值

目的了解宫颈细胞学异常患者中人乳头瘤“毒（HPV）的感染状况,评估HPV检测在宫颈病变筛查中的价值。方法随机选取宫颈薄层液基细胞学检测异常的101例患者进行了HPV检测,同时行组织病理学检查。结果（1）101例宫颈细胞学异常患者中,细胞学为ASCUS、LSIL、HSIL、鳞状细胞癌时高危型HPV阳性率分别为84．2％、88．6％、100．0％和2／2;（2）10l例细胞学异常患者中20例为CINI,81例为CINⅡ及以上级别,高危型HPV阳性率存CINI、CINⅡ及以上级别分别为60％、97．5％;（3）ASCUS组中,高危型HPV阳性患者中CINⅡ及以上病变的发生率为87．5％,HPV阴性患者中CINⅡ及以上病变的发生率为16．7％;（4）高危型HPV型别分布由高到低分别为HPVl6型39．6％（40／101）,HPV58型17．8％（18／101）,HPV52型16．8％（17／101）,HPVl8型9．9％（10／101）以及HPV33型9．9％（10／101）。结论高危型HPV感染率与宫颈病变级别呈正相关;HPV检测可作为ASCUS患者的有效分流手段。宫颈病变患者中高危型HPV感染以16、58、52、18、33型为主。     

人乳头瘤病毒检测在宫颈病变中的应用价值

Objective To detect the human papillomavirus(HPV) infectious condition in women with abnormal cytology and evaluate its values in the screening of high grade cervical intraepithelial lesion.Method 1O1 patients who underwent thinprep cell test(TCT) with abnormal cervical cytology were selected to undergo HPV test, all subjects also received tissue biopsy at the same time. Results ( 1 )Among the 101 patients,the incidence rates of high risk HPV infection of those with ASCUS, LSIL, HSIL and squamous cell carcinoma were 84. 2% ,88.6% , 100. 0% and 2/2 respectively. (2)Among the patients with abnormal cytology,the number of patients with pathologically confirmed results of CIN Ⅰ and CIN Ⅱ or worse were 20 and 81, the incidence rates of high risk HPV infection of those with CIN Ⅰ and CIN Ⅱ or worse were 60.0% and 97.5% respectively. (3) In the ASCUS group, the incidence rates of CIN Ⅱ or worse with high risk HPV infection were 87.5% and the incidence rates of CIN Ⅱ or worse without high risk HPV infection were 16.7%. (4)The prevalence of high risk HPV types from highest to lowest order were follow: HPV16 (39. 6% ) ,58( 17. 8% ) ,52 ( 16. 8% ), 18 ( 9. 9% ) ,33 ( 9.9% ). Conclusions The infection rate of high risk HPV was positively correlated with the levels of cervical lesions. HPV test is a good triage approach for the patients with ASCUS. HPV16,58,52,18,33 are the most common in the patients of cervical lesions.     

高危型人乳头状瘤病毒和宫颈细胞学联合检测在诊断宫颈病变中的临床价值

目的 探讨高危型人乳头状瘤病毒(hish-risk human papillomavirus,HR-HPV)和宫颈细胞学联合检测在诊断宫颈病变中的临床价值.方法 对2004年10月至2006年12月北京大学第一医院就诊的患者进行HR-HPV检测和宫颈细胞学检查,对一项或两项结果异常者均行阴道镜下宫颈活检,并以宫颈活检结果为金标准,比较HR-HPV检测、宫颈细胞学检查、HR-HPV和宫颈细胞学联合检测对宫颈病变的诊断价值.结果 HR-HPV检测、宫颈细胞学检查及HR-HPV检测联合宫颈细胞学检查对诊断宫颈病变有不同价值.HR-HPV检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为94.83%、31.06%、55.22%、87.02%,宫颈细胞学筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为92.10%、31.06%、54.50%、81.43%,HR-HPV和宫颈细胞学联合检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为99.65%、18.55%、61.46%、97.62%.结论 采用HR-HPV和宫颈细胞学联合检测可提高宫颈病变的检出率,并可指导临床医生对宫颈病变的治疗.     

宫颈上皮内瘤样病变135例三年随访分析

目的 探讨宫颈薄层细胞学检查（TCT）和HPV检测联合筛查在宫颈上皮内瘤样病变（CIN）诊治和随访中的作用.方法 对2006年进行细胞学检查异常,且组织病理学诊断为宫颈上皮内瘤样病变的患者共135人进行病例回顾性总结,并在2006年至2009年进行连续随访,对其进行TCT和HPV检测.结果 （1）73例高危型HPV阳性的患者中,15例为ASCUS,3例为ASCUS-H,28例为LSIL,27例为HSIL;17例为CINⅠ,24例为CINⅡ,30例为CINⅢ,2例为CINⅢ可疑早侵.（2）3次随访中未出现CIN复发或病理升级情况.结论 HPV检测联合宫颈细胞学检查法在宫颈上皮内瘤样病变的诊治和随访中具有重要的意义.     

PRINS技术在人乳头状瘤病毒检测中的应用

ＰＲＩＮＳ技术在人乳头状瘤病毒检测中的应用吕亚利钟梅赵坡ＰＲＩＮＳ技术在人乳头状瘤病毒检测中的应用@吕亚利@钟梅@赵坡...     

人乳头瘤病毒16型内变异株与宫颈病变

目的 研究患宫颈上皮内瘤变（Cervical intraepithelial neoplasia,CIN）的汉族妇女中人乳头瘤病毒（Human papillomavirus,HPV）16型内变异株的类型及其在临床上的意义.方法 随机收集中日友好医院妇科门诊就诊的77例感染HPV16的汉族患者的宫颈脱落细胞DNA,用PCR法扩增HPV16型包含E6和E7基因的DNA片段并测序.通过对测序得到的E6基因序列与GenBank下载的参考株的比对,研究77例汉族患者中HPV16变异株的类型并探讨其与CIN的关系.结果 纳入研究的77例患者中,最小年龄21岁,最大年龄56岁,平均年龄36.39±6.86岁.其中,CIN Ⅱ级以下病变16例（占比20.8%）,CIN Ⅱ级及以上病变61例（占比79.2%）.HPV16型内变异株只有亚洲株和欧洲株两种,亚洲株38例,欧洲株39例.经χ^2检验,χ^2=0.0034,P〉0.05,尚不支持亚洲株与欧洲株的致癌作用不同.结论 虽然本研究未发现HPV16型亚洲株与欧洲株的致癌作用不同,但本研究发现77例汉族患者感染的HPV16型内变异株以亚洲株和欧洲株为主,故我们有理由推测,HPV16型内变异株在我国汉族妇女中的分布以亚洲株和欧洲株为主,而其他变异株,特别是高致癌的亚美株并不常见.     

潮州地区高危型人乳头瘤病毒载量与宫颈病变的关系

目的探讨高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)载量与宫颈病变级别之间的关系。方法采用RT-PCR对农村35～60岁女性进行HR-HPV DNA定量检测并记录CT值,2 731例阳性者再进行核酸分子快速导流杂交分型技术(HybriMax)和液基薄层细胞学(thinprep liquid-based cytologic test,LCT)检查;对低级别鳞状上皮内病变(low grade squa-mous intraepithelial lesion,LSIL)及以上病变行阴道镜下组织病理学活检。根据LCT及病理活检结果按病变级别分成5组:无上皮内瘤变或恶性病变(non-squamous intraepithelial lesion or neoplasia,NILM)、未明确诊断意义的不典型鳞状上皮细胞(atypi-cal squamous cells of undetermined significance,ASCUS)、LSIL、高级别鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)和鳞状细胞癌(squamous cell cacinoma,SCC)。在同级别宫颈病变中,按照HPV感染的类型分为4组:HPV52、HPV16、HPV58和多重HPV感染。采用方差分析的方法对各组平均CT值进行统计分析。结果随宫颈病变级别的升高,CT均值降低,5组CT均值间差异均具有显著性(P<0.05)。在同级别宫颈病变中,NILM组HPV58和多重HPV差异有显著性(P<0.05),ASCUS组HPV16和多重HPV差异有显著性,其余病变级别各HPV感染组间差异均无显著性(P>0.05)。结论 HR-HPV载量与宫颈病变级别呈正相关,高HR-HPV载量是影响宫颈病变级别的危险因素。     

机会性筛查人群中高危型人乳头瘤病毒与宫颈病变相关性的分析

目的 研究第二代杂交捕获法(HC2)高危型人乳头瘤病毒(HR-HPV)检测阳性样品中HPV与宫颈病变的相关性.方法 随机抽取HC2阳性患者602名(344名行细胞学检查),采用PCR-反向点杂交(RDB)法对HPV分型并分析HPV型别与细胞学的相关性.结果 602例患者PCR阳性率94.5%;HPV分型检出率依次为HPV16、52、58、56、39等;HC2检测谱外单独感染24例;HPV16、HPV16/18与ASCUS、LSIL、HSIL有明显相关性.结论 机会性筛查人群中最常见HPV型别依次为HPV16、52、58;HC2检测的假阳性率为4.0%;HPV16与宫颈病变程度相关.     

人乳头瘤病毒感染检测及其临床意义

目的 探讨宫颈癌及癌前病变、尖锐湿疣与人乳头瘤病毒感染的关系,为早期防治宫颈癌提供临床依据.方法 标本来源于2004年1月至2005年8月期间重庆第三军医大学西南医院皮肤科、妇产科和解放军三○二医院皮肤科就诊的1086例患者,在未接受任何检查及治疗、无任何干预措施的情况下,采用荧光定量PCR技术对病变标本HPV-DNA进行检测;用上述方法无法明确HPV型别的标本,采用基因芯片技术检测.结果 CIN Ⅰ、CINⅡ和宫颈鳞癌的标本中,HPV的检测率均为100%,以HPV16型感染为主,但存在两种以上HPV型别感染.在子宫内膜癌中主要是HPV18,仍然存在HPV多种型别混合感染.636例女阴尖锐湿疣中,HPV阳性率为96.70%,其中以HPV6（44.97%）和HPV11（29.40%）为主,少数患者是HPV16和（或）HPV18感染,也有少数为两种以上甚至四重HPV感染.结论 子宫及宫颈瘤变主要以高危型HPV16和18为主,外阴生殖道的尖锐湿疣以低危型HPV6和HPV11为主,但两者都可合并有多种型别的HPV混合感染,给临床治疗和患者机体病理生理改变造成一定的复杂性.对HPV感染型别进行早期鉴定和监测,对提高广大妇女的生活质量有重大意义.     

机会性筛查人群中高危型人乳头瘤病毒与宫颈病变相关性的分析

目的 研究第二代杂交捕获法(HC2)高危型人乳头瘤病毒(HR-HPV)检测阳性样品中HPV与宫颈病变的相关性.方法 随机抽取HC2阳性患者602名(344名行细胞学检查),采用PCR-反向点杂交(RDB)法对HPV分型并分析HPV型别与细胞学的相关性.结果 602例患者PCR阳性率94.5%;HPV分型检出率依次为HPV16、52、58、56、39等;HC2检测谱外单独感染24例;HPV16、HPV16/18与ASCUS、LSIL、HSIL有明显相关性.结论 机会性筛查人群中最常见HPV型别依次为HPV16、52、58;HC2检测的假阳性率为4.0%;HPV16与宫颈病变程度相关.     

Concomitant infections with human papillomavirus and various mycoplasma and ureaplasma species in women with abnormal cervical cytology

PurposeThe objective of the present study is to verify possible association between infections with mycoplasmas and ureaplasmas and the presence of HPV infections in women diagnosed with abnormal cervical cytology.Material/MethodsThe investigation included 387 non-pregnant women among whom: 62 were diagnosed with ASCUS, 167 with LSIL, 27 with HSIL, 49 with cervical carcinomas, and 82 females with normal cytology.The presence of HPV infection and identification of both ureaplasma and mycoplasma were confirmed by PCR using specific primers.ResultsHPV infections were demonstrated in 156 females (40%), with mycoplasmas and/or ureaplasmas were confirmed in 93 cases (24%).In HPV-positive patients, infections with mycoplasmas/ureaplasmas were more frequent, particularly for ureaplasmas (U. urealyticum p=0.004, U. parvum p=0.027). The percentage of females infected with U. urealyticum significantly increased in women diagnosed with cervical carcinoma as compared to controls.The statistical analysis demonstrated that the risk of HPV infection while already infected with any of the four analyzed species of Mycoplasmataceae increased two-fold. With concomitant of U. urealyticum infection, the risk of HPV infection was 4.7-fold greater than in the absence U. urealyticum infection.ConclusionSince the presence of U.urealyticum associates significantly with the HPV infection, genotyping of the ureaplasma species should be recomended.     

Distribution of human papillomavirus among women with abnormal cervical cytology in Kuwait

This study investigates the distribution of human papillomavirus (HPV) in women with abnormal cervical cytology in Kuwait. Two hundred and ninety‐eight (298) abnormal ThinPreps were taken from women seeking routine gynecological care and screened for HPV DNA by real‐time PCR. HPV genotyping was determined by PCR‐based sequencing. HPV DNA was detected in 152 women (51%), and 29 different HPV genotypes were detected, comprising 16 high‐risk (HR) (16, 18, 31, 33, 35, 39, 45, 51, 53, 56, 58, 59, 66, 68, 73, 97), nine low‐risk (LR) (6, 11, 54, 61, 74, 81, 90, 102, 106), and four intermediate‐risk (IR) (62, 67, 84, 87). HPV16 had the highest prevalence (24.3%), followed by HPV11 (13.8%), HPV66 (11.2%), HPV33 (9.9%), HPV53 (9.2%), HPV81 (9.2%), HPV56 (7.9%) and HPV18 (6.6%). HPV prevalence was 86, 67, and 89% in women with invasive cervical carcinoma (ICC), high‐grade squamous intraepithelial lesion (HSIL) and low‐grade squamous intraepithelial lesion (LSIL), respectively. As for age distribution, 69% of all HPVs were found in women aged 20–29 years, and the HPV incidence rate deceased with increasing age. The proportion of single infections decreased as the severity of the cytological diagnosis increased, while the proportion of multiple infections increased. This study is the first of its type in Kuwait and one of few in the Middle East. The findings are consistent with the hypothesis that HPV infection is the primary cause of cervical neoplasia. They support HPV vaccine research to prevent cervical cancer and efforts to develop HPV DNA diagnostic tests. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc.     

Human papillomavirus DNA detection in women with normal and abnormal cervical Pap cytology

Cervical cancer is the second most common cancer in women worldwide and nearly all cases are human papillomavirus (HPV) related. Pap cytology screening has been very successful in lowering cervical cancer incidence and mortality in the US. With the increasing use of HPV DNA tests as a reflex test for ASC-US and co-testing of women over 30 for primary screening, there have been many reports of the HPV positive rates and clinical follow-up findings for women with various abnormal Pap diagnoses. This review describes the reported HPV detection rates for HSIL, LSIL, ASC-US, ASC-H, AGC, and negative Pap cytology and highlights the effect of HPV positivity on the follow-up detection of cervical lesions.     

Prevalence of human papillomavirus among women with normal cervical cytology in Kuwait

This study was undertaken to determine the prevalence and type specific distribution of human papillomavirus (HPV) in women with normal cervical cytology in Kuwait. The study is the first of its type in Kuwait and one of few in the Middle East. The age specific distribution of HPV types was determined in 3,011 ThinPrep samples taken from women seeking routine gynaecological care. ThinPrep samples were screened for HPV DNA by real-time PCR. The type specific distribution of the viruses was determined by PCR-based sequencing. The results showed that HPV DNA was detected in 71 women (2.4%), and 21 different HPV genotypes were detected, comprising eight high-risk (HR) (16, 31, 33, 53, 56, 58, 66, and 73), seven low-risk (LR) (6, 11, 54, 61, 70, 81, and 90), four intermediate-risk (IR) (67, 82, 83, and 84) and HPV 102 and HPV 106. LR HPV types were found in 71.8% of infected samples, HR types in 32.3%, and IR types in 7%. With regard to age, 40.8% of all HPVs were found in women 30-39 years of age, 29.6% in women 40-49 years of age, 19.7% in women over 50 years and 9.9% in women less than 34 years old. The study shows that the prevalence of HPV infection in Kuwait is among the lowest in the world and suggests that HPV vaccine could prevent the development of HPV associated cervical cancer in 1.39% of young females living in Kuwait. However, more extensive population-based studies should be undertaken before implementing HPV vaccination.     

Prevalence of anal cytological abnormalities in women with positive cervical cytology

The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty‐nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high‐grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re‐infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323–327. © 2010 Wiley‐Liss, Inc.