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目的评价第二代杂交捕获(HC-Ⅱ)法检测高危型人乳头瘤病毒(HR-HPV)DNA对宫颈癌前病变诊治的临床应用价值。方法2006年9月至2009年3月对中日友好医院妇科门诊就诊的2761名妇女行宫颈癌前病变筛查,HC-Ⅱ法检测HR-HPV DNA,联合液基细胞学(LBC)检查,二者中任一或两者检测阳性者,进一步行阴道镜检查和活检。结果组织病理学诊断为HPV相关性病变97例,宫颈上皮内瘤样病变(CIN)Ⅰ221例,CINⅡ152例,CINⅢ178例,宫颈浸润癌(ICC)20例。不同宫颈病变中HR-HPV DNA的阳性率分别为HPV相关性病变78.35%(76/97),CINⅠ87.33%(193/221),CINⅡ94.74%(144/152),CINⅢ100%(178/178),ICC100%(20/20),P<0.05。HC-Ⅱ法检测HR-HPV DNA病毒负荷量在不同宫颈病变中分别为HPV相关性病变512.15±764.19,CINⅠ753.95±978.27,CINⅡ871.08±1003.52,CINⅢ603.40±740.25,ICC466.44±673.05,P<0.05。结论随着宫颈癌前病变级别的升高,HC-Ⅱ法检测HR-HPV DNA的阳性率显著上升;病毒负荷量与宫颈癌前病变程度无关。HC-Ⅱ检测在宫颈癌前病变的筛查、管理和治疗后随访过程中具有重要价值。
Objective To evaluate the clinical value of second generation hybridization capture (HC-Ⅱ) in the detection of high-risk human papillomavirus (HR-HPV) DNA in the diagnosis and treatment of cervical precancerous lesions. Methods From September 2006 to March 2009, 2761 women who visited the gynecology clinic of Sino-Japan Friendship Hospital were screened for cervical precancerous lesions, HR-HPV DNA was detected by HC-Ⅱ method and combined with liquid-based cytology (LBC) Both or both test positive, further colposcopy and biopsy. Results Histopathology was diagnosed as HPV-related lesions in 97 cases, cervical intraepithelial neoplasia (CIN) in 221 cases, CINⅡ in 152 cases, CINⅢ in 178 cases and invasive cervical carcinoma (ICC) in 20 cases. The positive rates of HR-HPV DNA in different cervical lesions were HPV-associated lesions 78.35% (76/97), CINⅠ87.33% (193/221), CINⅡ94.74% (144/152), CINⅢ100% (178 / 178), ICC 100% (20/20), P <0.05. The HR-HPV DNA viral load detected by HC-Ⅱ method were HPV-related lesions of 512.15 ± 764.19, CINⅠ753.95 ± 978.27, CINⅡ871.08 ± 1003.52, CINⅢ603.40 ± 740.25, ICC466.44 ± 673.05 , P <0.05. Conclusions With the increase of precancerous lesions, the positive rate of HR-HPV DNA detected by HC-Ⅱ method is significantly increased. The viral load is not related to the degree of cervical precancerous lesions. HC-Ⅱ detection in cervical precancerous lesions screening, management and treatment of follow-up process of great value.