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HPV基因分型检测在宫颈高级别病变治疗后的应用进展
引用本文:林婷婷,孙蓬明,宋一一. HPV基因分型检测在宫颈高级别病变治疗后的应用进展[J]. 国际妇产科学杂志, 2017, 44(4): 381. DOI: 10.3969/j.issn.1674-1870.2017.04.004
作者姓名:林婷婷  孙蓬明  宋一一
作者单位:福建医科大学附属福建省妇幼保健院, 福州,350001
摘    要:高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)持续性感染是宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和宫颈癌发生的主要原因。宫颈高级别病变患者在标准治疗后疾病进展风险仍高于正常人群。治疗后HR-HPV阳性、细胞学异常、切缘阳性等是宫颈高级别病变残留/复发的预测因子。HPV基因分型检测能明确治疗后HR-HPV的不同感染状态,有助于检出高风险人群。相较治疗后HR-HPV新发感染和再发感染,同一亚型HR-HPV持续感染与宫颈高级别病变治疗后的疾病残留/复发密切相关。HPV16/18型是宫颈高级别病变患者治疗后最常见的持续感染型别,有更高的疾病残留/复发风险,临床上应加强随访力度。与单纯细胞学、HR-HPV检测相比,随访HR-HPV基因分型能提高预测宫颈高级别病变治疗后疾病残留/复发的敏感度,同时保持相似甚至更高的特异度。

关 键 词:乳头状瘤病毒科  基因  宫颈上皮内瘤样病变  随访研究  肿瘤,残余  复发

Application Progress of HPV Genotyping Test in High-Grade Cervical Lesions after Treatment
LIN Ting-ting,SUN Peng-ming,SONG Yi-yi. Application Progress of HPV Genotyping Test in High-Grade Cervical Lesions after Treatment[J]. Journal of International Obstetrics and Gynecology, 2017, 44(4): 381. DOI: 10.3969/j.issn.1674-1870.2017.04.004
Authors:LIN Ting-ting  SUN Peng-ming  SONG Yi-yi
Abstract:High risk human papillomavirus (HR-HPV) persistent infection is the major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Women after standard treatment for high-grade CIN (HG-CIN) are at higher risk of subsequent disease compared to the general population. After treatment, HR-HPV positive, cytological abnormalities, positive margins were the predictors of residual/recurrent disease after treatment of cervical high-grade lesions. HPV genotyping can be used to identify the different infection status of HR-HPV after treatment, which is helpful for detecting the high-risk groups. The persistent infection of the same type HR-HPV was closely associated with the residual lesions or recurrence after treatment of HG-CIN compared with the HR-HPV new infection or recurrent infection. HPV16/18 is the most common type of persistent infection in patients with HG-CIN, which has a higher risk of residual lesions or recurrent disease and need to closely follow-up. HPV genotyping increases sensitivity for the detection of residual or recurrent disease after treatment for HG-CIN than cytology and HR-HPV testing, remains equal or better sensitivity.
Keywords:Papillomaviridae  Genes  Cervical intraepithelial neoplasia  Follow-up studies  Neoplasm  residual  Recurrence
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