高危型人乳头瘤病毒检测作为宫颈癌初筛手段的应用研究

目的探讨高危型人乳头瘤病毒(human papilloma virus,HPV)检测作为宫颈癌及癌前病变初筛手段的可行性。方法选取2011年5月至2012年5月深圳市香蜜湖街道1 000名自愿参加宫颈癌筛查的妇女作为观察组,以高危型HPV检测作为初筛方法,阳性者进一步行液基细胞学检查(liquid-based cytology test,LCT),结果≥非典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)者行阴道镜下宫颈活检,以病理诊断为确诊标准;以同期于深圳市计划生育服务中心就诊的行联合筛查(高危型HPV+LCT)的体检妇女600名为对照,进行高级别宫颈病变及宫颈癌的人群发病率的比较分析。结果1观察组高危型HPV感染率8.80%(88/1 000)。不同文化程度分组中小学及以下、大学及以上两组感染率较高,分别为12.99%(10/77)、14.21%(27/190),与其它两组比较差异有统计学意义(P0.05);不同年龄、职业及不同性生活年限分组中的各组感染率比较,差异无统计学意义(P0.05)。2高危型HPV初筛组高级别宫颈病变及宫颈癌的人群发病率为1.40%(14/1 000),联合筛查组的人群发病率为1.83%(11/600),差异无统计学意义(P0.05)。结论以高危型HPV检测作为宫颈癌人群普查的初筛手段高效、可行。

Application study of utilizing high -risk HPV examination as a preliminary screening method on cervical cancer

Objective To discuss the feasibility of utilizing high -risk human papillomavirus examination ( HR-HPV-E) as preliminary screening proxy on the cervical cancer and precancerous lesions .Methods A total number of 1 000 women from Xiangmi Lake street, who were voluntary to take the preliminary screening test on the cervical cancer from May 2011 to May 2012 were chosen as the observation group .They were conducted the HR -HPV-E.According to the examination , the ones with positive results were further conducted by the liquid -based cytology test ( LCT) .Biopsy under colposcopy were conducted on the patients who failed the LCT [ test results≥( atypical squamous cells of undetermined significance , ASCUS) ] and the pathological analyses were viewed as the final diagnosis.The control group, consisting of 600 women who were advised to take the combination detections (HPV+LCT)in the Family Planning Service Center in Shenzhen City from May 2011 to May 2012, was founded for comparative analysis on the incidence rate of the cervical cancer and precancerous lesions .Results ① The total infection rate of the HR -HPV in observation group was 8.80 %.The observation group was subdivided into sub -groups on the basis of different standards .The infection rates of two sub -groups “elementary school and lower ” and “university and higher” were 12.99 % and 14.21 %, higher than the other two sub -groups, and the differences were statistically significant (P<0.05).It appeared that the age, career and sex history sub -groups had no statistical differences ( P>0.05) on the infection rate .② The incidence rates of the cervical cancer and precancerous lesions in observation group was 1.40 %and that of the control group was 1.83 %, the difference was not statistically significant ( P>0.05 ) . Conclusion HR-HPV-E is an inexpensive , effective and feasible preliminary screening proxy for the general investigation on the cervical cancer .