高危型人乳头瘤病毒感染低危型女性：发生率、患者特征及宫颈癌临床意义。
High-risk human papillomavirus infection in low risk women: incidence, patient characteristics, and clinical meaning for cervical cancer.
机构信息
Department of Obstetrics and Gynecology, Saint Vincent's Hospital, The Catholic University of Korea, Suwon, Kyungki-do, Korea.
出版信息
Int J Med Sci. 2012;9(1):103-7. doi: 10.7150/ijms.9.103. Epub 2011 Dec 15.
OBJECTIVE
To investigate the incidence of high-risk human papillomavirus (HPV) infection and its clinical meaning.
METHODS
Total 28,339 women attending our hospital for routine gynecologic care underwent Papanicolaou test (PAP test) and high-risk HPV tests. Biopsies were taken from some women and their results were compared.
RESULTS
The prevalence of high-risk HPV infection is 24.15%. And the women aged 20-29 years had the highest prevalence (32.3%) compared to 30-70 years (P<0.05). Of the 28,339 women, 1369 (4.83%) had positive PAP test (ASCUS, LSIL, HSIL). Of the 1369 PAP-positive patients, only 16 (1.17%) were negative for HPV test. Of the 1353 patients positive on both tests, 510 (37.7%) had lesions higher than CINII on histology. Of the 1,611 patients who underwent biopsies, 350 underwent the loop electrical excision procedure, with 339 (96%) being positive for HPV test, including 16 with CINI, 48 with CINII/III, 74 with CIS, and 16 with cervical cancer. HPV test had a positive predictive value of 40.7% and a negative predictive value of 100% for higher than CINII.
CONCLUSION
Although HPV test has a burden of cost, considering its high negative predictive value, HPV test should be considered for more useful screening test.
目的
研究高危型人乳头瘤病毒（HPV）感染的发生率及其临床意义。
方法
对我院 28339 例行常规妇科检查的妇女进行巴氏试验（PAP 试验）和高危型 HPV 检测。对部分妇女进行活检，并对其结果进行比较。
结果
高危型 HPV 感染率为 24.15%。20-29 岁年龄段的妇女感染率最高（32.3%），明显高于 30-70 岁年龄段（P<0.05）。28339 例妇女中，1369 例（4.83%） PAP 试验阳性（ASCUS、LSIL、HSIL）。在 1369 例 PAP 阳性患者中，HPV 检测仅 16 例（1.17%）为阴性。在两项检测均阳性的 1353 例患者中，510 例（37.7%）组织学病变高于 CINII。在 1611 例接受活检的患者中，350 例行环形电切术，其中 339 例（96%） HPV 检测阳性，包括 16 例 CINI、48 例 CINII/III、74 例 CIS 和 16 例宫颈癌。HPV 检测对高于 CINII 的阳性预测值为 40.7%，阴性预测值为 100%。
结论
虽然 HPV 检测有一定的经济负担，但考虑到其高阴性预测值，HPV 检测可作为更有用的筛查试验。
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