高危型人乳头状瘤病毒检测在宫颈癌筛查中的价值

目的评价人乳头状瘤病毒（HPV）DNA检测在宫颈癌筛查中的价值。方法采用第二代杂交捕获（HC-Ⅱ）技术和液基细胞学测试（LCT）2种方法 ,对1026例在妇科病中心就诊的受检者进行同步盲法检测,同时进行阴道镜检查。以宫颈活检组织病理学检查结果为诊断标准。评价该方案在宫颈癌筛查中的应用价值。结果病理检查结果显示,宫颈上皮内瘤变（CIN）-Ⅰ级152例,CIN-Ⅱ级108例,CIN-Ⅲ级109例,宫颈浸润癌28例。筛查高危型HPV感染366例,阳性率35.70%,在不同宫颈病变中的阳性率分别是：宫颈癌92.90%（26/28）,CIN-Ⅲ90.0%（99/109）,CIN-Ⅱ88.90%（96/108）,CIN-Ⅰ87.50%（133/152）。高危HPV对宫颈高级别病变的敏感性、特异性、阳性预测值,阴性预测值分别是98.60%、86.10%、14.80%和99.80%;HPV与LCT联合检测（平行试验）的以上各指标分别是100.00%、80.90%、12.10%和100.00%。结论高危型人乳头状瘤病毒检测在宫颈癌前病变的筛查中有较高的敏感度和阴性预测值,联合LCT检测是目前宫颈癌筛查具有诊断价值的方法 。

The Value of High Risk Human Papillomavirus Detection for Cervical Cancer Screening

Objective To investigate the value of high risk human papillomavirus（HPV）DNA dectection for cervical cancer screening.Methods Hybrid capture Ⅱ（HC-Ⅱ）human papillomavirus（HPV）test and liquid based cytology test（LCT）were performed in 1026 patients treaed in Xuzhou No.1 hospital from May 2008 to May 2009,and the abnomal cytological or HPV DNA findings were further biopsied under the colposcopeto to appraise the appicational importance of each approach for screening cervical cancer.Results Pathological results showed that cervical intraepithelial neoplasial（CIN）Ⅰin 152 patients,CIN Ⅱ in 108 patients,CIN Ⅲ 109 patients,invasive cervical cancer in 28 patients.HPV infected 366 patients in detection,with 35.70% positive rate.The infection rate of HPV in cervical cancer was 92.9%（26/28）,in CIN Ⅲ was 90.8%（99/109）,in CIN Ⅱ was 88.9%（96/108）,and in CIN Ⅰwas 87.5%（133/152）.The pathological results treated as standard,the sensitivity,soecificiy,positive prevalue,negative prevalue of HC-Ⅱ HPV for detecting high-grade cervical lesions were 98.6%,86.1%,14.8% and 99.8%.The values for HPV-LCT parallel test were 100.0%,80.9%,12.1% and 100%.Conclusion High-risk HPV DNA test is of high sensitivity and negative-predictive value.The combination of HCⅡ HPV and LCT tests are of great value for screening cervical cancer at present.