目的 分析人乳头瘤病毒在女性感染者中的分布特征,评估HPV-DNA分型检测用于筛查宫颈癌的临床价值.方法 选择行宫颈癌筛查的患者2560例.采集患者宫颈细胞进行HPV-DNA检测,对HPV-DNA高危型阳性患者行液基细胞学(TCT)检测,TCT阳性者行阴道镜取活检病理检测.结果 2560例妇女中共检测出HPV-DNA阳性者711例(27.8%),其中高危型265例(10.4%),低危型446例(17.4%).不同分级宫颈病变中HPV类型感染分布差异有统计学意义(P<0.05).HPV-DNA高危型感染以30岁以下和50岁以上的人群感染率较高,各年龄段患者HPV-DNA高危型感染率差异无统计学意义(χ2=5.673,P=0.339).HPV-DNA高危型感染者中病理诊断为宫颈癌患者10例(3.8%),低危型感染者中病理诊断为宫颈癌者2例(0.4%),二者差异有统计学意义(P<0.05).TCT联合HPV-DNA分型检测的敏感度高于二者单独检测,特异度和假阳性率低于HPV-DNA分型检测,假阴性率低于二者单独检测,差异均有统计学意义(P<0.05).结论 高危型HPV检测用于筛查宫颈癌敏感性和特异性高,可作为辅助宫颈细胞学检测的手段,临床应用价值较高.%Objective To analyze the distribution characteristics of the high-risk human papillomavirus in infected women and evaluate the clinical value of HPV-DNA typing in screening of cervical cancer.Methods Selected 2560 cases of cer-vical cancer screening.Collected the cervical cells for HPV-DNA detection,then the positive of high risk HPV-DNA were given TCT detect,and the positive TCT were given biopsy pathlolgical test.Results There were 711 cases of HPV-DNA positive in 2560 women(27.8%),in which 265 were high-risk type(10.4%),and 446 patients(17.4%)had low risk.There were signif-icant differences in the distribution of HPV types in different grades of cervical lesions(P<0.05).The risk of HPV-DNA infec-tion was high in patients less than 30 and over 50,no significant difference was found in all ages in patients with high risk HPV-DNA infection(χ2=5.673,P=0.339).There were 10 cases(3.8%)of cervical cancer with high risk of HPV-DNA infection and 2 cases(0.4%)with low risk of HPV-DNA infection,the difference was statistically significant(P<0.05).TCT and HPV-DNA test was more sensitive than the 2 individual test,specificity and false positive rate was lower than the HPV-DNA type of de-tection,the false negative rate of less than 2 test alone,the differences were statistically significant(P<0.05).Conclusion High risk HPV test in screening cervical cancer sensitivity and specificity,it can be used as a tool for cervical cytology,and has a high clinical application value.
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