高危型HPV负荷量与宫颈癌及其前期病变关系的研究

目的:探讨高危型HPV负荷量与宫颈癌及其前期病变的关系。方法:对2005年1月至2006年12月于本院行宫颈癌筛查的1221例患者临床资料进行统计分析,观察高危型HPV负荷量和宫颈癌及其前期病变的关系,并用ROC曲线分析,确定HC-Ⅱ法检测高危型HPV-DNA判断宫颈病变≥CINⅡ理想的RLU/CO界值。结果:1221例患者组织学诊断为慢性宫颈粘膜炎667例,CIN407例(其中CINⅠ109例、CINⅡ～Ⅲ298例),宫颈癌147例。慢性宫颈炎、CINⅠ、CINⅡ～Ⅲ和宫颈癌患者高危HPV-DNA负荷量的中位数分别为32.58,58.16,103.83和173.68。根据ROC曲线,统计结果中各可能切点的灵敏度和特异度,发现确定预测≥CINⅡ宫颈病变最佳RLU/CO值为3.155,该点灵敏度88%,特异度57%,Youden指数0.446。结论:高危型HPV负荷量与宫颈癌及其前期病变存在明显相关性,预测≥CINⅡ宫颈病变高危HPV负荷量最佳值为3.155。

The correlation of high-risk type human papillomavirus load with cervical carcinoma and precancerous lesions

Objective:To determine the association between high-risk type human papillomavirus(HR-HPV)load and cervical carcinoma and precancerous lesions.Methods:1221 patients who came to screen for cervical carcinoma were observed.Their clinical data was analyzed,using ROC curve to make the cut-off value of RLU/CO by hybrid capture Ⅱ(HCⅡ).Results:Among 1221 patients,there were 667 chronic cervicitis,407 CIN,(109 CINⅠ and 298 CIN Ⅱ~Ⅲ)and 147 cervical carcinoma.The median load of HR-HPV in chronic cervicitis,CINⅠ,CINⅡ~Ⅲ and cervical carcinoma was 32.58,58.06,103.83 and 173.68 respectively.According to ROC curve,the optimum cut-off of RLU/CO value was 3.155.Of this point,the sensitivity was 88%,while the specificity was 57%,the Youden index was 0.466.Conclusion:There is prominent association between viral load of HR-HPV and cervical carcinoma and precancerous lesions.The optimum cut-off of RLU/CO value to predict the lesion worse than CINⅡ is 3.155.