HPV感染检测在基层妇女宫颈病变筛查中的应用分析

摘要

目的 评价人乳头状瘤病毒( HPV)感染检测在基层妇女宫颈病变筛查中的应用价值. 方法 选择2012年5月至2014年4月期间在永嘉县人民医院妇产科及永嘉县妇保院进行妇科检查的630例宫颈疾病妇女为研究对象,同时进行薄层液基细胞学( TCT)及高危型HPV-DNA检测,并对TCT及HPV-DNA阳性者在阴道镜下取多点宫颈组织进行活检,以病理诊断结果作为金标准,比较两种检测方法在基层妇女宫颈病变筛查中的应用效果,观察不同年龄段妇女HPV感染分布情况. 结果 在630例患者中,HPV-DNA阳性率为30.32%,TCT阳性率为28.09%,两种检测方法阳性率比较差异无统计学意义(χ2 =0.752, P>0.05);但HPV-DNA检测敏感度及特异度均稍高于TCT检测方法,两种方法联合检测能够将敏感度及特异度进一步提高.HPV-DNA阳性者中,≥30岁妇女感染率为64.92%,显著高于30岁以下者的34.83%(χ2 =34.020,P<0.01). 结论 宫颈病变妇女HPV-DNA阳性率较高,在TCT基础上,联合HPV感染检测有助于宫颈病变性质的进一步筛查,对于30岁以上的妇女更具检测价值.%Objective To evaluate the application value of detecting human papilloma virus ( HPV ) infection in screening of cervical lesions of grass-root women.Methods During the period of May 2012 to April 2014, 630 women with cervical diseases examined in obstetrics and gynecology department of People' s Hospital of Yongjia County and Maternity Hospital of Yongjia County were recruited in the research, and they undertook ThinPrep cytology test ( TCT) and high risk HPV-DNA testing, and biopsy was done for cases with TCT and HPV-DNA positive results.Pathology results were taken as gold standard.Application effects of two methods were compared and HPV infection was observed among women at different ages.Results Among 630 patients, the positive rate of HPV-DNA was 30.32%and the positive rate of TCT was 28.09%.There was no significant difference in positive rate of two methods (χ2 =0.752,P>0.05).But the sensitivity and specificity of HPV-DNA detection method were slightly higher than those of TCT detection method, and the combined detection with two methods could further improve the sensitivity and specificity.Among HPV-DNA positive subjects, infection rate of women≥30 was 64.92%, which was significantly higher than that of women below 30 (34.83%) (χ2 =34.020,P<0.01).Conclusion HPV-DNA positive rate is high among women with cervical lesions.Combining TCT with HPV detection is helpful for screening cervical lesions, which is more valuable for women over 30.