HPV检测联合阴道镜检查对宫颈癌前病变的诊断价值

目的:探讨人乳头瘤病毒(humanpapillomavirus,HPV)检测联合阴道镜检查对宫颈癌前病变(CIN)的诊断价值。方法:选择2008年以来在厦门大学附属中山医院行宫颈分泌物HPV-DNA高危型检查并经阴道镜下定位活检、病理学确诊的456例(包括HPV-DNA阳性183例,阴性273例)患者,根据患者年龄、HPV-DNA高危型检查结果及活检病理结果进行总结、分析。结果:183例HPV-DNA高危型阳性患者中有73例为宫颈癌前病变,而273例HPV-DNA高危型阴性患者中只有29例为宫颈癌前病变,两组之间比较差异有统计学意义(P<0.01)。HPV阳性组中20～29岁年龄组HPV感染所占比例最高(55.19%),>40岁组HPV感染比例最低(18.03%),HPV阳性患者不同年龄段的CIN级别各组之间比较差异无统计学意义(P>0.05),HPV阴性患者随着年龄的增加CIN级别逐渐加重(P<0.05)。结论:HPV-DNA高危型阳性组发生宫颈癌前病变较阴性组发生癌前病变明显增多,HPV阳性患者宫颈病变的级别与年龄无相关性,HPV阴性患者的CIN级别随年龄增长而升高,HPV检测联合阴道镜检查对宫颈癌前病变诊断有重要价值。

Value of HPV detection combined with colposcopy in diagnosis of cervical precancerous lesion

Objective:To explore the value of HPV detection combined with colposcopy in diagnosis of cervical precancerous lesion.Methods:456 cases receiving high risk HPV-DNA detection of cervical secretions and diagnosed definitely by localized biopsy under colposcope and pathological examination were selected,including 183 cases with positive HPV-DNA and 273 cases with negative HPV-DNA;the data were summarized and analyzed according to age,results of high risk HPV-DNA detection and pathological results.Results:Among 183 cases with positive HPV-DNA,73 cases were diagnosed as cervical precancerous lesion;but among 273 cases with negative HPV-DNA,only 29 cases were diagnosed as cervical precancerous lesion,there was significant difference between the two groups(P<0.01);in positive HPV group,the proportion of HPV infection in 20~29 years group was the highest(55.19%),the proportion of HPV infection in more than 40 years group was the lowest(18.03%);in positive HPV group at different age stages,there was no significant difference among different CIN grades(P>0.05);in negative HPV group,the grades of CIN increased with age(P<0.05).Conclusion:The incidence of cervical precancerous lesion in positive high risk HPV-DNA group is significantly higher than that in negative high risk HPV-DNA group,there is no correlation between grades of cervical lesions and age in positive HPV group;in negative HPV group,the grades of CIN increase with age,HPV detection combined with colposcopy plays an important role in diagnosis of cervical precancerous lesion.