| 叶芳,秦伟,张坦如,等.门诊病人人类乳头瘤病毒分型在宫颈病变筛查中的应用[J].安徽医药,2020,24(4):726-729. |
| 门诊病人人类乳头瘤病毒分型在宫颈病变筛查中的应用 |
| Application of HPV typing and high?risk types in cervical lesions screening in outpatients |
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| DOI：10.3969/j.issn.1009?6469.2020.04.023 |
| 中文关键词: α乳头状瘤病毒属 宫颈肿瘤 宫颈非典型增生 DNA探针， HPV 阴道镜检查 薄层液基细胞学 |
| 英文关键词: Alpha papillomavirus Uterine cervical neoplasms Uterine cervical dysplasia DNA probes,HPV Colposcopy Liquid?based cytology test |
| 基金项目:国家自然科学基金( 21772201) |
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| 中文摘要: |
| 目的分析医院门诊就诊病人人类乳头瘤病毒( HPV)高危、中危及低危基因型分布状况，并探究高危型人类乳头瘤病毒(HR?HPV)检测在宫颈病变筛查中的作用。方法选取 2017年 3月至 2018年 4月在中国科学院合肥肿瘤医院就诊的妇科门诊病人 1 814例，分别采用反向点杂交法技术检测及 HPV分型检测，分析高危、中危及低危共 28种基因型分布状况。另外选择同期进行 HR?HPV检测、宫颈薄层液基细胞学检查( TCT)和阴道镜及病理组织学检查病人 210例，以病理组织学结果为参考标准，研究 HR?HPV、TCT以及两者联合检测用于宫颈病变筛查效能。结果 1 814例门诊病人共 176例 HPV检测阳性，阳性率为 9.70%，其中高危型或高危型混合中、低危型阳性率为 6.94%(126/1814)；中、低危型及混合感染阳性率 2.76%(50/1814)。基因型排名前十位分别是 HPV?16、58、52、53、66、56、18、31、33、42，其中 HPV?53、66和 42是中低危型。 HR?HPV联合 TCT诊断宫颈病变的灵敏度为 97.01%(65/67)，阴性预测值为 96.78%(60/62)，漏诊率为 2.99%。HR?HPV联合 TCT检测分别与 HR?HPV、TCT比较，均差异有统计学意义( χ2=5.220，5.372，P＜0.05)。结论合肥地区 HPV基因亚型分布不同其他地区，有待于进一步确认。 HR?HPV联合 TCT检测优于单项检查，对早期发现宫颈病变的具有重要筛选意义，可值得在妇科门诊广泛应用推广。 |
| 英文摘要: |
| Objective To analyze the distribution of high?risk，medium?risk and low?risk human papillomavirus(HPV)genotypesin outpatients of hospital，and to explore the role of high?risk human papillomavirus(HR?HPV)detection in cervical lesions screen? ing.Methods A total of 1814 gynecological outpatients who were admitted to the Hefei Cancer Hospital of the Chinese Academyof Sciences from March 2017 to April 2018 were selected.The reverse dot hybridization method and HPV typing test were used toanalyze the distribution of 28 genotypes with high?risk，medium?risk and low?risk.In addition，210 patients were selected for HR? HPV detection，cervical thin layer liquid?based cytology(TCT)，colposcopy and histopathological examination.The histopathologicalresults were used as the reference standard to study the efficacy of HR?HPV，TCT，and HR?HPV combined with TCT in screening for cervical lesions.Results A total of 176 patients with 1814 outpatients had positive HPV test，with a positive rate of 9.70%.The positive rate of high risk type or mixed medium and low risk type was 6.94%(126/1814).The positive rate of medium?risk，low? risk，and mixed infections was 2.76%(50/1814).The top 10 genotypes were HPV?16，58，52，53，66，56，18，31，33 and 42，amongwhich HPV?53，66 and 42 were medium?risk and low?risk types.The sensitivity of HR?HPV combined with TCT in the diagnosis ofcervical lesions was 97.01%(65/67)，the negative predictive value was 96.78%(60/62)，and the rate of missed diagnosis was 2.99%.HR?HPV combined with TCT was compared with HR?HPV and TCT，respectively.The differences were statistically signifi? cant(χ2=5.220，5.372，respectively，P＜0.05).Conclusion The distribution of HPV genotypes in Hefei is different from other re? gions，and further confirmation is needed.HR?HPV combined with TCT detection is better than single examination，which has impor? tant screening significance for the early detection of cervical lesions，and can be widely used in gynecological outpatient department. |
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