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高危型HPV DNA 检测在宫颈不典型鳞状细胞再分类中的意义

Role for High-risk HPV DNA Testing in Reclassification of ASC

  • 摘要: 目的 明确高危型人乳头瘤病毒基因(high risk human papillomavirus DNA,HR-HPV DNA)检测在宫颈不典型鳞状细胞(atypical squamous cell,ASC)再分类中的意义,为其临床应用提供依据。方法 我院2002年于山西省阳城县和襄垣县进行的“中国山西宫颈癌普查方法研究”项目中,9034名妇女均进行了液基细胞学检查、HR-HPVDNA检测和5%醋酸染色肉眼观察。我们对其中细胞学诊断为ASC,伴有HR-HPVDNA检测阳性或5%醋酸染色肉眼观察异常的病例进行了阴道镜检查及活检,比较HR-HPVDNA阳性ASC组和HR-HPV DNA阴性-5%醋酸染色肉眼观察阳性ASC组中宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN)的发生率,从而评价HR-HPVDNA检测作为ASC再分类方法的可行性。结果 在进行阴道镜检查的548例ASC中,HR-HPV DNA阳性者有333例(60.8%),HR-HPV DNA阴性-肉眼观察阳性者215例(39.2%)。这两组ASC中CIN的发生率分别为22.5%和5.1%(P〈0.05);CIN2/3的发生率分别为7.8%和0.9%(P〈0.05)。结论 HR-HPV DNA检测是ASC再分类的有效方法。

     

    Abstract: Objective  To define the significance of high-risk human papillomavirus DNA ( HR-HPV DNA) testing in reclassification of atypical squamous cell (ASC), and provide scientific basis for its clinical utility. Methods  A total of 9034 women were enrolled in a cervical cancer screening program in Shanxi China, in 2002. In this program, all subjects were examined by liquid2based cytology, HR-HPV DNA testing and unaided visual inspection with acetic acid (5 %) . Of them, the cases of ASC with positive HPV DNA and negative HPV DNA-positive unaided visual inspection were taken colposcopic biopsy. We compared the incidence of cervical intraepithelial neoplasia (CIN) between the positive HPV DNA group of ASC and the negative HPV DNA-positive unaided visual inspection group of ASC. Results  There were 548 cases of ASC, who were taken colposcopic biopsy. Of the 548 cases, 333 (60. 8 %) cases were HPV DNA-positive, 215 (39. 2 %) cases were negative HPV DNA-positive unaided visual inspection. In HPV DNA positive group, the incidence of CIN is 22. 5 %,while the incidence of CIN2/ 3 is 7. 8 %. Both were significantly higher than that of negative HPV DNA2positive unaided visual inspection group (5. 1 % and 0. 9 %) . Conclusion  HR-HPV DNA testing is a feasible method for reclassification of ASC.

     

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