文章摘要
陈跃1 刘青云1 陈国群1 喻利华1 李献忠1 张怡2.人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究[J].,2011,11(12):2328-2330
人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究
人乳头状瘤病毒DNA 检测在宫颈病变筛查中的应用研究
  
DOI:
中文关键词: 宫颈癌  人乳头瘤病毒  薄层液基细胞学  宫颈上皮内瘤样病变
英文关键词: Cervical cancer  Human papilloma virus  Thinprep cytology test  Cervical intraepithelial neoplasia
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作者单位
陈跃1 刘青云1 陈国群1 喻利华1 李献忠1 张怡2 湖南宁乡县人民医院 
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中文摘要:
      目的:探讨高危型人乳头状瘤病毒(HR-HPV)DNA 检测方法在宫颈病变筛查中的应用意义。方法:580 例妇女同时进行薄 层液基细胞学(TCT)、第2 代杂交捕获法(HC II)和阴道镜下宫颈组织活检,并以病理组织学检查结果作为确诊标准进行对比分 析。结果:①580 例受检者中病理诊断为炎症207 例(35.69%),CIN I 224 例(38.62%),CIN II 96 例(16.55%),CIN III 38 例 (6.55%),浸润癌15 例(2.58%);②TCT 检测异常者中炎症52 例(25.12%),CIN I 177 例(79.02%),CIN II 85 例(88.54%),CIN III 36 例(94.74%),浸润癌15 例(100%),其中CIN II 和CIN III 组间差异无统计学意义(P>0.05),但显著高于炎症组和CIN I 组,低 于湿润癌组(P<0.01 或0.05);③HPV DNA 检测阳性者中炎症66 例(31.88%),CIN I 152 例(67.86%),CIN II 83 例(86.46%),CIN III 35 例(92.11%),浸润癌组15 例(100%), 除CIN II 和CIN III 组间差异无显著性外(P>0.05),其余各组间差异均有统计学意义 (P<0.05 或0.01),且HPV-DNA 检测阳性组CIN 和浸润癌发病率明显高于阴性组(P<0.01);④30 岁以下高危险型HPV 感染率 (65.53%)显著高于30 岁以上34.47%感染率(P<0.01);⑤联合应用TCT、HPV-DNA 检测诊断宫颈癌及癌前病变的敏感度和特异 度分别为96.14%和69.28%,高于TCT 或HPV-DNA 的单独检测。结论:宫颈高危险型HPV 感染是CIN 及宫颈癌的主要发病因 素,并与病变严重程度密切相关,而HPV-DNA 和TCT 联合应用可提高宫颈癌及癌前病变的检出率。
英文摘要:
      Objective: To evaluate the application of human papillomavirus (HPV) test in screening cervical epithelial lesions. Methods: 580 cases were tested by thinprep cytology test (TCT), hybrid capture (HC-II) and histopathology, then comparative analysis was performed by using the results of pathologic examination as diagnosis criteria. Results: ①By pathological examination, 207 (35.69%), 224 (38.62%), 96 (16.55%), 38(6.55%)and 15(2.58%)women were diagnosed as inflammation, CIN I, CIN II, CIN III and cervical cancer, respectively. ② Among cases with abnormal cytology, 52 (25.12%)were inflammation, 177 (79.02%)CIN I, 85 (88.54%)CIN II, 36 (94.74%)CIN III, and 15 (100%)cervical cancer, and there was a significant difference within groups (P<0.05). ③ Among the HPV DNA positive cases, 66(31.88%)were inflammation, 152(67.86%)CIN I, 83(86.46%)CIN II, 35(92.11%)CIN III, and 15(100%)cervical cancer, and significant difference were found among the groups (P<0.05 or 0.01), but not between CIN II and CIN III (P>0.05). Notably, the incidence of CIN and cervical cancer in HPV positive group were higher than HPV negative group (P<0.01). ④ HPV detection rates in ≥30 years group was 65.53%, significantly higher than 34.47% in <30 years group (P<0.01). ⑤The combination of TCT and HPV-DNA test had better sensitivity (96.14%) and specificity (69.28%) than used alone. Conclusion: HPV infection is the main risk factor for CIN and cervical carcinoma, and plays an important role in the pathogenesis. The combination of HPV-DNA and TCT could improve detection rate of preinvasive and invasive cervical carcinoma.
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