高危型人乳头瘤病毒负荷量检测合并年龄因素在宫颈病变筛查中的作用
Effects of High-risk Human Papillomavirus DNA Viral Load and Age in Screening of Cervical Lesions
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摘要: 目的探讨高危型人乳头瘤病毒负荷量检测在宫颈病变筛查中的作用。方法回顾性分析2006年9月—2009年6月青岛大学医学院附属医院妇科门诊初诊女性患者1 301例，采用第二代杂交捕获法(HC-2)检测高危型HPV，其中454例患者因伴有高危因素而行阴道镜下活检。结果HPV的总感染率为51.04%（664/1301）。≤25岁组感染率最高55.68%(49/88)。在≤35岁年龄组，高危型HPV DNA负荷量与其阴道镜下活检的病理结果之间不存在线性关系（P=0.6207），各组之间两两比较均无统计学意义（P=0.0658）。在＞35岁年龄组，1＜HPV＜10 pg/μl、10≤HPV＜100 pg/μl两组，HR-HPV高低所对应的宫颈病变程度构成比差异无统计学意义（P=0.081）；在100≤HR-HPV＜1 000 pg/μl、HR-HPV≥1 000pg/μl两组，HR-HPV高低对所对应的宫颈病变程度构成比差异也无统计学意义（P=0.1058）；但是，HR-HPV＜100 pg/μl所对应的宫颈病变程度构成比与HR-HPV≥100 pg/μl所对应的构成比比较差异有统计学意义(P<0.0001)。在＞35岁的女性患者中，当HR-HPV≥100 pg/μl时，CINⅢ和宫颈浸润癌的患者所占比例较高，而HR-HPV＜100 pg/μl时，患者中慢性宫颈炎和CINⅠ类型的病变所占比例较高，CINⅡ在两组中呈现不稳定趋势。结论重视女性年龄和高危型HPV负荷量在宫颈病变筛查中的协同作用，可以明显提高临床筛查的有效性和敏感度。Abstract: ObjectiveTo investigate the effects of high-risk human Papillomavirus(HR-HPV) DNA viral load and age in screening of cervical lesions．MethodsHR-HPV DNA viral in a total of 1 301 cases were detected by hybrid capture Ⅱ testing 454 cases received cervical biopsy because of high-risk factors. ResultsOverall HR-HPV infection prevalence was 51.04% (664/1301), furthermore in women ≤25 years old it was the highest among all age groups(55.68%,49/88). In women aged ≤35, the correlation coefficient between viral load and cervical lesion severity was not statistically significant (P=0.6207). In women aged＞35, it had significantly the constituent ratio differences of cervical lesion severity between HR-HPV＜100 pg/μl and HR -HPV≥100 pg/μl (P<0.0001). In women aged＞35 with HR-HPV≥100 pg/μl，the prevalence of CIN Ⅲ and invasive cervical carcinoma was higher than those in others. While the prevalence of Chronic cervicitis and CINⅠ in HR-HPV <100 pg/μl is higher than those in others.It had unstable trend about the prevalence of CINⅡ in all population. ConclusionIt could improve the validity and sensitivity of cervical lesions diagnosis by clinical screening high-risk human papillomavirus DNA viral load.
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