HPV-DNA检测在宫颈病变筛查中的应用

目的:通过HPV-DNA检测筛查妇女宫颈病变,以评价该方法的应用价值。方法:收集2008年3月~2010年11月在齐齐哈尔医学院附属第三医院就诊的,年龄45~59岁762例宫颈病变疑似病例,采用第二代杂交捕获技术进行HPV-DNA检测,以宫颈刮片病理诊断为确诊结果。结果:HPV-DNA检测筛查HPV阳性率为86.74%,高于宫颈刮片筛查HPV的阳性率(χ2=216.81,P<0.01),筛查CINⅠ、CINⅡ、CINⅢ、宫颈浸润癌的约登指数分别为43.29%、53.70%、57.02%、72.17%;Kappa值分别为0.419、0.550、0.562、0.715;阳性预测值分别为80.42%、83.49%、84.09%、80.70%。结论:HPV-DNA检测筛查妇女宫颈病变具有较高真实性、可靠性和预测性,建议联合应用其他技术用于宫颈病变的检验。

Application of HPV-DNA detection in screening of cervical lesions

Objective:To evaluate the application value of human papillomavirus DNA(HPV-DNA) detection by screening cervical lesions.Methods:762 cases aged 45~59 years old who were suspected of cervical lesions and had hospitalized in the hospital from March 2008 to November 2010 were collected,hybrid captureⅡ(HCⅡ) technology was used for HPV-DNA detection,the pathological diagnosis of cervical scraping was used as confirmed diagnosis.Results:The HPV positive rate of HPV-DNA detection was 86.74%,which was significantly higher than that of cervical scraping(χ2=216.81,P<0.01).The Youden indexes of screening for CINⅠ,CINⅡ,CIN Ⅲ and invasive cervical carcinoma were 43.29%,57.82%,57.02% and 72.17%,respectively;Kappa values were 0.419,0.550,0.562 and 0.715,respectively;the positive predictive values were 80.42%,83.49%,84.09% and 80.70%,respectively.Conclusion:HPV-DNA detection has high authenticity,reliability and predictability in screening of cervical lesions,it is recommended to combine with other technologies for cervical lesions inspection.