人乳头瘤病毒检测阴性子宫颈癌的研究进展

子宫颈癌是妇科最常见的恶性肿瘤,研究证实99.7%的宫颈癌是因感染人乳头瘤病毒（human papillomavirus,HPV）造成的,但几乎所有的研究中都发现有HPV检测阴性的子宫颈癌存在。HPV检测阴性的子宫颈癌可以概括为假阴性和真阴性两种情况,造成假阴性的原因有病变小、取材有限、病毒载量低、非高危人乳头瘤病毒基因型、技术错误或检测灵敏度不足等。现有的筛查方式具有一定局限性,一些具有高灵敏度和特异性的新型分子标记物如微小核糖核酸、FAM19A4基因甲基化等已被证明有望作为子宫颈癌早期检测和诊断的指标。近年来关于HPV阴性子宫颈癌的研究越来越多,但对HPV阴性子宫颈癌患者临床特点的分析存在差异。本文主要对HPV阴性子宫颈癌假阴性的原因、筛查诊断及临床特点方面进行综述。

Review of human papillomavirus negative cervical cancer

Cervical cancer is the most common malignant tumor in gynecology.Studies have confirmed that 99.7% of cervical cancer is caused by human papillomavirus (HPV),but almost all studies have found the presence of HPV negative cervical cancer.HPV test negative cervical cancer can be summarized as false negative and true negative conditions.The causes of false negative include smaller disease,limited resources,low viral load,non-high-risk HPV genotype,technical errors or insufficient detection sensitivity.Existing screening methods have certain limitations,and some novel molecular markers with high sensitivity and specificity,such as microRNAs and methylation of FAM19A4 gene,have been proved to be promising for the early detection and diagnosis of cervical cancer.In recent years,there are more and more studies on HPV negative cervical cancer,but there are differences in the analysis of clinical characteristics of HPV negative cervical cancer patients.This article mainly reviews the causes,screening diagnosis and clinical characteristics of HPV false-negative cervical cancer.