Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Gynecology and Obstetrics, The Northwest Women and Children Hospital, Xi'an, Shaanxi, China.
J Med Virol. 2018 Jan;90(1):165-171. doi: 10.1002/jmv.24902. Epub 2017 Oct 17.
To evaluate the effectiveness of Human papillomavirus16/18 infection referral to colposcopy in cervical cancer screening for women aged 25 years and older in Chinese northwest region Shaan'xi province. A total of 2224 women were diagnosed with primary high-risk HPV infection by HPV-DNA genotyping technology during August 2014 to August 2015. A total of 1916 cases referred for colposcopy with histological evidence were enrolled, including 1124 women with HPV16/18 genotype and 792 with other High-risk human papillomavirus genotypes. A total of 1916 women aged 25 years and older with HR-HPV positive were referred to colposcopy. The distribution of HPV16, HPV18, and other HR-HPVs infection were 49.22%, 9.45%, and 41.33%, respectively. 71.56% had normal cervical histology, 7.05% had Cervical Intraepithelial Neoplasia1, 8.82% had CIN2, 7.25% had CIN3, and 5.32% had cervical cancer. The percentage of positivity of HPV16 and HPV18 was highly associated with the relative risk of cervical lesion. The sensitivity and specificity of HPV16/18 for detection of CIN2+ (CIN3+) was 82.68% (92.12%) and 47.87% (46.15%), respectively. The positive predictive value and negative predictive value of HPV16/18 for detection of CIN2+ (CIN3+) was 30.16% (19.75%) and 91.03% (97.60%), respectively. HPV16 and HVP18 are the most common genotypes in high grade cervical lesions in Shaan'xi province. Meanwhile, these two types play predominant roles in the progression of high grade cervical lesion. Primary HPV16/18 detection has high sensitivity and negative predictive value in cervical cancer screening and the strategy for women with HPV16 and HPV18 infection referral to colposcopy is efficient and feasible in northwestern region of China.
评估 HPV16/18 感染转诊行阴道镜检查在陕西西北区 25 岁及以上女性宫颈癌筛查中的效果。2014 年 8 月至 2015 年 8 月,应用 HPV-DNA 基因分型技术对 2224 例初治高危型 HPV 感染妇女进行诊断。共纳入 1916 例 HPV16/18 型和其他高危型 HPV 型别均为阳性行阴道镜检查的病例,包括 HPV16/18 基因型 1124 例,其他高危型 HPV 基因型 792 例。25 岁及以上 HR-HPV 阳性妇女共 1916 例转诊阴道镜检查。HPV16、HPV18 和其他 HR-HPV 感染的分布分别为 49.22%、9.45%和 41.33%。71.56%宫颈组织病理学正常,7.05%为宫颈上皮内瘤变Ⅰ级,8.82%为 CIN2,7.25%为 CIN3,5.32%为宫颈癌。HPV16 和 HPV18 的阳性率与宫颈病变的相对风险高度相关。HPV16/18 检测 CIN2+(CIN3+)的敏感性和特异性分别为 82.68%(92.12%)和 47.87%(46.15%)。HPV16/18 检测 CIN2+(CIN3+)的阳性预测值和阴性预测值分别为 30.16%(19.75%)和 91.03%(97.60%)。HPV16 和 HVP18 是陕西省高级别宫颈病变中最常见的基因型。同时,这两种类型在高级别宫颈病变的进展中起主要作用。原发性 HPV16/18 检测在宫颈癌筛查中具有较高的敏感性和阴性预测值,对 HPV16 和 HPV18 感染妇女转诊阴道镜检查的策略在中国西北地区是有效且可行的。