人乳头瘤病毒检测在宫颈癌筛查中的作用

目的探讨人乳头瘤病毒(HPV)在宫颈癌筛查中的作用。方法用薄层液基细胞涂片法进行宫颈细胞学检查，对细胞学异常患者采用第二代杂交捕获试验检测高危型HPV DNA。 HPVDNA检测阳性和细胞学检测结果为非典型鳞状细胞或低度鳞状上皮内病变(LISL)以上患者，均行阴道镜下活组织病理检查。分析HPV感染与宫颈上皮内瘤变的关系。结果HPV DNA检出率随宫颈病变程度加重呈上升趋势。非典型鳞状细胞者中HPV检测阳性为31.4％，HPV阳性的非典型鳞状细胞患者中51.1％为宫颈上皮内瘤变或更严重病变。结论HPV DNA检测在宫颈癌筛查中可作为细胞学的辅助手段提高诊断准确性，减少细胞学结果为轻度异常患者不必要的阴道镜检查。高危型HPV检测可指导早期HPV感染者的治疗及用于惠者的追踪随访。

HPV DNA Testing and Cytological Detection for Cervical Cancer Screening

Objective To investigate the effect of human papillomavirus (HPV) as an adjunct for primary screening on cervical cancer.Methods All cytological specimens exfoliated from cervix (collected by clinician) were prepared using the AutoCyte Pap Smear fluid-based system. The Hybrid Capture II assay detected 13 types of high-risk HPV DNA. All women with Pap Smear showed atypical squamous cells of undetermined significance (ASCUS). Colposcopy and histological examination on cervical tissue were performed in the patients, who had ASCUS and positive results of high-risk HPV DNA. Women with ASC-H (moderate or severe dyskaryosisor worse) should directly undergo colposcopy examination regardless of HPV status.Results HPV infection rates increased according to the seriousness degree of cervical lesions. Of the patients with ASCUS and positive results of high-risk HPV DNA, 51.1% were found to have intracervical neoplasm (CIN).Conclusions HPV DNA testing is very important to improve the diagnostic accuracy and limit the unnecessary colposcopy examination in the patients with borderline and mildly abnormal cytological test results. Earlier detection of high-risk HPV types can instruct the treatment and follow-up of the infected patients.