[1]游珂,耿力*,郭艳利,等.高危型人乳头瘤病毒以及病毒载量检测在诊断宫颈上皮内瘤变Ⅱ级及以上病变中的应用[J].中国微创外科杂志,2007,07(11):1096-1098.
　You Ke,Geng Li,Guo Yanli,et al.Highrisk Human Papillomavirus and the Detection of Viral Load in the Diagnosis of CINⅡ and Ⅲ or Cervical Cancer[J].Chinese Journal of Minimally Invasive Surgery,2007,07(11):1096-1098.
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高危型人乳头瘤病毒以及病毒载量检测在诊断宫颈上皮内瘤变Ⅱ级及以上病变中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年11期
页码:
1096-1098
栏目:
出版日期:
2007-11-20

文章信息/Info

Title:
Highrisk Human Papillomavirus and the Detection of Viral Load in the Diagnosis of CINⅡ and Ⅲ or Cervical Cancer
作者:
游珂; 耿力*; 郭艳利; 乔杰; 沈晓野; 姚燕君; 范晓红; 司胜丹; 白丽
北京大学第三医院妇产科，北京100083
Author(s):
You Ke;  Geng Li;  Guo Yanli;  et al.
Department of Gynaecology and Obstetrics, Peking University Third Hospital, Beijing 100083, China
关键词:
宫颈细胞学; 宫颈病变; 高危型HPV人乳头瘤病毒
Keywords:
Cervical cytology; Cervical neoplasia; Highrisk human papillomavirus
分类号:
R737.33;R730.261
文献标志码:
A
摘要:
目的探讨高危型人乳头瘤病毒（highrisk human papillomavirus，HrHPV）在液基细胞学异常患者中对宫颈上皮瘤变Ⅱ级（cervical intraepithelial neoplasia，CINⅡ）及以上病变（CINⅢ、宫颈癌）的辅助诊断作用。方法选择2179例宫颈液基细胞学异常并行HrHPV检测以及阴道镜检查加宫颈活检的患者进行回顾性分析，统计采用χ2检验，并行单因素Logistic回归分析。不能明确意义的不典型鳞状细胞（atypical squamous cells undetermined significance，ASCUS）占46.5％（1013/2179）,不除外高度上皮内瘤变的不典型鳞状细胞（atypical squamous cell which cannot exclude high grade squamous intraepithelial lesion，ASCH）4.1％（89/2179），低度鳞状上皮内病变(low squamous intraepithelial lesion，LSIL)34.7％（757/2179），高度鳞状上皮内病变(highgrade squamous intraepithelial lesion，HSIL)及以上占11.6%（253/2179）,非典型腺细胞（atypical gland cells，AGC）3.1％（67/2179）。结果经阴道镜下宫颈活检病理诊断CINⅡ103%(224/2179)，CINⅢ64%(140/2179)，鳞癌1.2％（27/2179），腺癌0.4％（9/2179）,其余81.6%(1779/2179)为宫颈低度病变（包括CINⅠ与湿疣）或慢性宫颈炎。在各种细胞学中，高危型HPV阳性时检出CINⅡ及以上病变的机会增加，在ASCUS、ASCH、LSIL、≥HSIL中，差异有显著性。当HrHPV病毒负荷量在0~09、1.0～9.9、10.0～99.9、100.0～999.9、≥1000.0时，CINⅡ及以上病变占22%（13/588）、9.7％（21/216）、24.9％（97/389）、29.8％（182/611）、23.2％（87/375）。将HPV载量做10的对数转化行Logistic回归检验，HPV载量每增加一个对数单位，CINⅡ及以上病变的机会增加1325倍。结论在宫颈细胞学异常的患者中检测HrHPV能辅助诊断CINⅡ及以上病变。
Abstract:
ObjectiveTo explore the role of highrisk human papillomavirus (HrHPV) DNA testing in the detection of cervical intraepithelial lesions (CIN) Ⅱ and Ⅲ, or cervical cancers for patients with abnormal cervical cytology. MethodsA total of 2197 patients with abnormal cervical liquidbased cytology, who had received HrHPV detection and colposcopy, were enrolled into this study. The data were analyzed using χ2test and Logistic regression. Among the patients, 1013 (46.5％) had atypical squamous cells undetermined significance (ASCUS), 89 (4.1％) had atypical squamous cell which cannot exclude high grade squamous intraepithelial lesion (ASCH), 757 (34.7％) low squamous intraepithelial lesion (LSIL), 253 (11.6%) highgrade squamous intraepithelial lesion (HSIL), and 67 (3.1％) atypical gland cells (AGC).ResultsPathological examination showed CINⅡ in 224 patients (10.3%), CIN Ⅲ in 140 (6.4%), cervical cancer in 27 (1.2％), and adenocarcinoma in 9 (0.4％). The other patients (1779/2179, 81.6%) had CINⅠ, condyloma, or chronic cervicitis. The detection rate of CIN Ⅱ and Ⅲ, and cervical cancer was increased in the patients with HrHPV. The differences in the rate among ASCUS, ASCH, LSIL, and HSIL patients were significant. The incidence rate of CINⅡ and Ⅲ, or cervical cancer was 2.2% (13/588), 9.7％ (21/216), 24.9％ (97/389), 298％ (182/611), and 23.2％ (87/375) for the patients with a HrHPV load of 0-0.9, 1.0-9.9, 10.0-99.9, 100.0-9999, and ≥1000.0. Logistic regression showed that the risk of CINⅡ and Ⅲ, and cervical cancer increased by 1.325 folds with the log of the HPV load. ConclusionsHrHPV DNA test is helpful for the detection of CIN Ⅱ and Ⅲ or cervical cancer in patients with abnormal cervical cytology.

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备注/Memo

备注/Memo:
*通讯作者
更新日期/Last Update: 2013-12-09