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采用HPV 16和HPV 18基因分型检测14种高危型人乳头瘤病毒用于宫颈癌筛查的评估。

Evaluation of the detection of 14 high-risk human papillomaviruses with HPV 16 and HPV 18 genotyping for cervical cancer screening.

作者信息

Bian Mei-Lu, Cheng Jiao-Ying, Ma Li, Cong Xiao, Liu Jun, Chen Ying, Chen Xi

机构信息

Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China.

出版信息

Exp Ther Med. 2013 Nov;6(5):1332-1336. doi: 10.3892/etm.2013.1309. Epub 2013 Sep 18.

Abstract

The American Society for Colposcopy and Cervical Pathology (ASCCP) suggests that women ≥30 years old, with a negative cytopathological test but a positive high-risk (HR) human papillomavirus (HPV) test should undergo HPV 16 and HPV 18 genotyping. If this test is positive, immediate cervical pathology is required. Therefore, the aim of this study was to evaluate the effectiveness and clinical value of testing for 14 HR HPVs with HPV 16 and HPV 18 genotyping for cervical cancer (CC) screening. A total of 424 females from the China-Japan Friendship Hospital were selected and randomly divided into two groups (A and B). All participants underwent two different testing methods: the liquid-based cytology test (LCT) and a HPV DNA test. For the HPV DNA test, participants in group A underwent the hybrid capture II (HC-II) testing method while participants in group B were tested using the quantitative polymerase chain reaction (qPCR; HBRT-H14) method. The sensitivity, specificity, positive predictive value and negative predictive value for the detection of cervical intraepithelial neoplasia (CIN) grade II or greater using HBRT-H14 were 96.30, 78.17, 23.21 and 99.68%, respectively. In Group B, compared with other HR HPV types, HPV 16 and HPV 18 infection led to the increased possibility of cervical lesions graded CIN II or higher (8.11 and 51.28%, respectively). A significant difference in the rates of CC and CIN II or higher was observed among women who were i) infected with HPV 16 and/or HPV 18, ii) infected with other HR HPV types and iii) diagnosed as negative for HR HPV infection (χ=93.976, P=0.0001). In conclusion, HBRT-H14 is applicable for CC screening with the advantage of genotyping for HPV 16 and HPV 18, which may help to improve triage management for women with negative cytology.

摘要

美国阴道镜及宫颈病理学会(ASCCP)建议,年龄≥30岁、细胞病理学检查结果为阴性但高危(HR)人乳头瘤病毒(HPV)检测结果为阳性的女性应进行HPV 16和HPV 18基因分型检测。如果该检测结果为阳性,则需要立即进行宫颈病理检查。因此,本研究的目的是评估检测14种HR HPV并进行HPV 16和HPV 18基因分型用于宫颈癌(CC)筛查的有效性和临床价值。选取了424名来自中日友好医院的女性,并将她们随机分为两组(A组和B组)。所有参与者都接受了两种不同的检测方法:液基细胞学检测(LCT)和HPV DNA检测。对于HPV DNA检测,A组参与者采用杂交捕获II(HC-II)检测方法,而B组参与者则使用定量聚合酶链反应(qPCR;HBRT-H14)方法进行检测。使用HBRT-H14检测宫颈上皮内瘤变(CIN)二级或更高级别病变的灵敏度、特异度、阳性预测值和阴性预测值分别为96.30%、78.17%、23.21%和99.68%。在B组中,与其他HR HPV类型相比,HPV 16和HPV 18感染导致宫颈病变分级为CIN II或更高的可能性增加(分别为8.11%和51.28%)。在i)感染HPV 16和/或HPV 18、ii)感染其他HR HPV类型以及iii)被诊断为HR HPV感染阴性的女性中,CC和CIN II或更高级别病变的发生率存在显著差异(χ=93.976,P=0.0001)。总之,HBRT-H14适用于CC筛查,具有对HPV 16和HPV 18进行基因分型的优势,这可能有助于改善细胞学检查结果为阴性的女性的分流管理。

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