高危型人乳头瘤病毒检测对宫颈病变的诊断价值

目的研究高危型人乳头瘤病毒（human papillomavirus,HPV）DNA检测对宫颈病变的诊断价值。方法对2009年1月～2012年1月7 098例在妇科进行液基细胞学（liquid-based cytology test,LCT）检查的患者,采用高危型人乳头瘤病毒（high-risk human papillomavirus,HR-HPV）分型测定,异常者行阴道镜下活检并分析。结果行LCT检查的7 098例妇女中,868例表现为LCT结果异常,873例表现为HR-HPV阳性,随着LCT结果宫颈异常程度的增加,HR-HPV感染率明显增加;868例异常的患者中病理学检查结果为浸润癌者HPV感染76例（100%）,宫颈上皮内瘤变（cervical intra-epithelial neoplasia,CIN）Ⅲ者HPV感染57例（98.3%）,CINⅡ者感染89例（81.7%）,CINⅠ者感染186例（73.2%）;浸润癌中LCT和HPV均阳性者占97.4%,CINⅢ中占91.4%,CINⅡ中占81.7%,CINⅠ中占72.8%。结论高危型HPV-DNA检测对宫颈病变诊断有重要价值,LCT结合HPV检查指导阴道镜下活检有重要意义。

Diagnostic value of high-risk HPV-DNA detection for cervical lesions

Objective To study the diagnostic value of high-risk HPV-DNA detection for cervical lesions.Methods 7 098 cases of patients detected by liquid-based cytology test（LCT） from January 2009 to January 2012 in Department of Gy naecology were given the detection of high-risk human papillomavirus（HR-HPV）,among them,the results were abnormal,colposcopy was given biopsy and the results were analyzed.Results 868 of 7 098 cases were abnormal by LCT,873 cases were positive by HR-HPV-DNA determination,HR-HPV infection rate was significantly increased with increasing results of the cervical abnormalities.Among 868 cases,76 cases（100%） was HPV-positive in invasive cancer patients,57 cases（98.3%） was positive in CINⅢ,89 cases（81.7%） was positive in CINⅡ,186 cases（73.2%） was positive in CINⅠ;97.4% was positive both LCT and HPV results in invasive cancer cases,and 91.4% was in CIN Ⅲ,81.7% was in CINⅡ,72.8% was positive in CINⅠ.Conclusion The HR-HPV-DNA detection has significant value for cervical lesions determination,LCT combination of HPV testing is important for the guidance of colposcopy biopsy.