论文部分内容阅读
目的探讨高危型人乳头状瘤病毒(HPV)的病毒负荷量与宫颈癌及宫颈上皮内瘤变(CIN)的相关性。方法选取2013年6月至2016年6月间北京市健宫医院收治的1056例行宫颈癌筛查的患者,对高危型HPV的脱氧核糖核酸(DNA)行第2代杂交捕获试验(HC-Ⅱ)半定量检测,予以受试者工作特征曲线(ROC曲线)分析,对CINⅡ及以上宫颈病变理想RLU/CO界值进行判定。结果慢性宫颈炎592例(56.1%);CIN395例(37.4%),CINI级110例(10.4%),CINⅡ~Ⅲ级285例(27.0%);宫颈癌69例(6.5%)。高危型HPV病毒负荷量随着宫颈病变程度的加深而增高,差异有统计学意义(P<0.05)。慢性宫颈炎、CINI级、CINⅡ~Ⅲ级及宫颈癌患者高危HPV-DNA病毒负荷量中位数分别为33.24、58.37、103.48和172.56。ROC曲线分析,预测CINⅡ级及以上宫颈病变的最佳RLU/CO值为3.173,其灵敏度和特异度分别为89.0%和58.0%,Youden指数为0.587。结论高危型HPV病毒负荷量与宫颈癌及前期病变有着显著的相关性,会随着病情严重程度的加深而增加,预测CINⅡ及以上宫颈病变高危HPV最佳负荷量值为3.173。
Objective To investigate the relationship between viral load of high-risk human papillomavirus (HPV) and cervical cancer and cervical intraepithelial neoplasia (CIN). Methods A total of 1056 cervical cancer screening patients admitted to Beijing Jian Gong Hospital from June 2013 to June 2016 were enrolled in this study. The second generation hybridization capture test (HC- Ⅱ) semi-quantitative detection, receiver operating characteristic curve (ROC curve) analysis, CIN Ⅱ and above cervical lesions ideal RLU / CO cut-off to determine. Results CIN395 cases (37.4%), CINI class 110 cases (10.4%), CIN Ⅱ ~ Ⅲ cases 285 cases (27.0%), cervical cancer cases (56.1%); The load of high-risk HPV increased with the degree of cervical lesions deepened, the difference was statistically significant (P <0.05). Chronic cervicitis, CINI grade, CIN Ⅱ ~ Ⅲ grade and cervical cancer patients with high-risk HPV-DNA virus load median were 33.24,58.37,103.48 and 172.56. ROC curve analysis showed that the best RLU / CO value was 3.173 for predicting cervical lesions of CIN level II and above. The sensitivity and specificity were 89.0% and 58.0%, respectively, and the Youden index was 0.587. Conclusion The load of high-risk HPV has a significant correlation with cervical cancer and precancerous lesions, and will increase with the severity of the disease. The optimal load of HPV with a high risk of cervical lesions of CINⅡ and above is 3.173.