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The Value of High Risk Human Papillomavirus Detection for Cervical Cancer Screening

【摘要】 目的 評價人乳頭狀瘤病毒(HPV)DNA檢測在宮頸癌篩查中的價值。 方法 采用第二代雜交捕獲(HCⅡ)技術和液基細胞學測試(LCT)2種方法,對1026例在婦科病中心就診的受檢者進行同步盲法檢測,同時進行陰道鏡檢查。以宮頸活檢組織病理學檢查結果為診斷標準。評價該方案在宮頸癌篩查中的應用價值。 結果 病理檢查結果顯示,宮頸上皮內瘤變(CIN)Ⅰ級152例,CINⅡ級108例,CINⅢ級109例,宮頸浸潤癌28例。篩查高危型HPV感染366例,陽性率3570%, 在不同宮頸病變中的陽性率分別是:宮頸癌9290%(26/28),CINⅢ900%(99/109),CINⅡ8890%(96/108),CINⅠ8750%(133/152)。高危HPV對宮頸高級別病變的敏感性、特異性、陽性預測值,陰性預測值分別是9860%、8610%、1480%和9980%;HPV與LCT聯合檢測(平行試驗)的以上各指標分別是10000%、8090%、1210%和10000%。 結論 高危型人乳頭狀瘤病毒檢測在宮頸癌前病變的篩查中有較高的敏感度和陰性預測值,聯合LCT檢測是目前宮頸癌篩查具有診斷價值的方法。【Abstract】 Objective To investigate the value of high risk human papillomavirus(HPV) DNA dectection for cervical cancer screening. Methods Hybrid capture Ⅱ(HCⅡ)human papillomavirus (HPV) test and liquid based cytology test (LCT) were performed in 1026 patients treaed in Xuzhou No.1 hospital from May 2008 to May 2009,and the abnomal cytological or HPV DNA findings were further biopsied under the colposcopeto to appraise the appicational importance of each approach for screening cervical cancer. Results Pathological results showed that cervical intraepithelial neoplasial(CIN)Ⅰin 152 patients,CIN Ⅱ in 108 patients,CIN Ⅲ 109 patients,invasive cervical cancer in 28 patients.HPV infected 366 patients in detection, with 3570% positive rate. The infection rate of HPV in cervical cancer was 929%(26/28),in CIN Ⅲ was 908%(99/109),in CIN Ⅱ was 889%(96/108),and in CIN Ⅰwas 875%(133/152).The pathological results treated as standard,the sensitivity, soecificiy, positive prevalue, negative prevalue of HCⅡ HPV for detecting highgrade cervical lesions were 986%,861%,148% and 998%.The values for HPVLCT parallel test were 1000%,809%,121% and 100%. Conclusion Highrisk HPV DNA test is of high sensitivity and negativepredictive value. The combination of HCⅡ HPV and LCT tests are of great value for screening cervical cancer at present.