HPV分型联合TCT检查在宫颈病变中的临床价值

摘要

Objective To investigate the prevalence of female HPV infection in Mianyang,and to explore the value of HPV typing combined with TCT in the diagnosis of female cervical lesions.Methods Testing results of 2491 patients who underwert both HPV21 typing and TCT during January 2015 to June 2016 in our hospital,were collected and analyzed.Results Among the 2491 patients,the HPV positive rate was 29.75％,with a majority of single infection,mainly HPV16,52,58 and 53.The HPV positive rate of 21 to 30-year-old age group was highest and the rate of CIN grade Ⅰ or higher lesion in 41 to 50-year-old age group was highest,mainly HPV16,52 and 58.In the prediction of cervical lesions,the sensitivity of single HPV typing and HPV typing com bined with TCT were 94.2％ and 100％,the specificity were 12％ and 28％,the positive predictive value were 74.71％ and 79.31％ and the negative predictive value were 42.86％ and 100％,respectively.As for positive detection rates of the two methods,the difference was statistically significant(P ＜ 0.05).Conclusion The infected female population of HPV at cervical tends to be younger in Mianyang area,with a majority of HPV16,52 and 58 infection.HPV typing combined with TCT examination can significantly reduce the rate of missed diagnosis and improve specificity of cervical lesion screening.%目的 了解绵阳地区女性HPV的感染情况,探讨HPV分型联合TCT检查在女性宫颈病变中的应用价值.方法 收集我院2015年1月至2016年6月期间同时进行HPV21分型与TCT检查的2491例患者检测结果,并进行统计分析.结果 2491例患者中,HPV阳性率29.75％,以单一感染为主,主要为HPV16、52、58和53型;21～30岁年龄组HPV阳性率最高,41 ～50岁年龄组CIN Ⅰ级以上病变率最高,主要以HPV16、52和58型为主;单一HPV分型检查与HPV分型联合TCT检查预测宫颈病变的灵敏度分别为94.2％、100％,特异性分别为12％、28％,阳性预测值分别为74.71％、79.31％,阴性预测值分别为42.86％、100％,两种方法阳性检出率差异有统计学意义(P＜0.05).结论 绵阳地区女性宫颈HPV感染趋于年轻化,以HPV16、52和58型感染为主;HPV分型联合TCT检查可以明显降低宫颈病变筛查的漏诊率,提高特异性.