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[高危型人乳头瘤病毒DNA检测在处理意义未明的非典型鳞状细胞和低级别鳞状上皮内病变中的应用]

[Use of high-risk human papillomavirus DNA testing to deal with atypical squamous cells undetermined significance and low squamous intraepithelial lesion].

作者信息

Guo Yan-li, You Ke, Geng Li, Zhang Xiao-wei, Shen Xiao-ye, Yao Yan-jun, Fan Xiao-hong

机构信息

Department of Gynaecology and Obstetrics, Peking University Third Hospital, Beijing 100083, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2006 Oct 18;38(5):480-2.

Abstract

OBJECTIVE

To explore the role of high-risk human papillomavirus (HPV) DNA testing in improvement of recognition of cervical intraepithelial lesions (CIN) 2, 3 or cervical cancer confirmed by biopsy in women with abnormal cervical cytology including atypical squamous cells undetermined significance (ASC-US) and low squamous intraepithelial lesion (LSIL).

METHODS

Total 940 patients with abnormal cervical liquid-based cytology including ASC-US and LSIL were included in this study. Hybrid capture II assay was applied in the high-risk HPV detection. The cervical pathologic diagnoses were obtained under colposcopy guided biopsy.

RESULTS

Of the 940 cases, 497 were ASC-US, and 443 LSIL. With pathological diagnosis of cervical biopsy, 417 cases were chronic inflammation, 315 condyloma, 124 CIN 1, 65 CIN 2, 19 CIN 3 or cervical cancer. The positive rate of high-risk HPV DNA in groups of ASC-US and LSIL were 59.6% and 84.9%, respectively. In each group of abnormal cytology, detection rates of CIN 2, 3 or cervical cancer in patients with positive HPV DNA were 8.8% and 14.1%, respectively, which were higher than those with negative HPV DNA (0.2% and 6.0%, P < 0.05). In group of ASC-US, high-risk HPV DNA test had a negative predictive value of 99.5%; detection rates of CIN 2, 3 or cervical cancer in patients with HPV DNA virus load 1-9.99 and > or = 10 was 1.6% and 10.7%, respectively.

CONCLUSION

High-risk HPV DNA test were helpful to improve the detection rates of CIN 2, 3 or cervical cancer in patients with ASC-US.

摘要

目的

探讨高危型人乳头瘤病毒(HPV)DNA检测在提高宫颈细胞学异常(包括意义不明确的非典型鳞状细胞(ASC-US)和低级别鳞状上皮内病变(LSIL))女性中经活检确诊的宫颈上皮内瘤变(CIN)2、3级或宫颈癌识别率方面的作用。

方法

本研究共纳入940例宫颈液基细胞学异常(包括ASC-US和LSIL)的患者。采用杂交捕获II法进行高危型HPV检测。在阴道镜引导下活检获取宫颈病理诊断。

结果

940例病例中,497例为ASC-US,443例为LSIL。经宫颈活检病理诊断,417例为慢性炎症,315例为尖锐湿疣,124例为CIN 1级,65例为CIN 2级,19例为CIN 3级或宫颈癌。ASC-US组和LSIL组高危型HPV DNA阳性率分别为59.6%和84.9%。在每组细胞学异常中,HPV DNA阳性患者的CIN 2、3级或宫颈癌检出率分别为8.8%和14.1%,高于HPV DNA阴性患者(0.2%和6.0%,P<0.05)。在ASC-US组中,高危型HPV DNA检测的阴性预测值为99.5%;HPV DNA病毒载量为1 - 9.99和≥10的患者中CIN 2、3级或宫颈癌的检出率分别为1.6%和10.7%。

结论

高危型HPV DNA检测有助于提高ASC-US患者中CIN 2、3级或宫颈癌的检出率。

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