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目的:了解遵义市部分妇女宫颈高危型人乳头瘤病毒(high-risk human papillomavims,HR-HPV)感染的主要类型、年龄分布、感染状况,探讨HPV DNA检测联合液基细胞学诊断宫颈病变的临床意义。方法:对1786名妇女用人乳头瘤病毒核酸扩增分型检测试剂盒检测16种HR-HPV病毒亚型,同时行宫颈薄层液基细胞学检测(TlfinPrep liquid based cytology test,TCT);对TCT和(或)HR-HPV为阳性者再进行病理学检查。结果:①HR-HPV阳性者376例占21.1%,细胞学结果有异常者342例为筛查人数的19.15%,意义不明确的不典型鳞状细胞(ASCUS)、低度鳞状(LSIL)是异常细胞学结果中最常见的两种约为73.1%;②对TCT和(或)HR-HPV为阳性者再行阴道镜下活组织检查,随着TCT的级别越高,阴道镜下活检符合率越高。LSIL级别以上TCT、HR-HPV以及两者均为阳性检出率3组间差异无统计学意义;③正常人群中年轻的性活跃妇女HPV感染率高(P<0.05);④遵义市妇女HPVl6型感染率最高(P<0.05),其次为HPV51型及18型。结论:①女性生殖道HR-HPV感染是宫颈癌及宫颈上皮内瘤样病变(cervical intraepithelial neoplasm,CIN)发病的主要危险因素之一,提示宫颈癌的防治重点应放在防止HPV感染和对HPV感染的筛查以及密切监测已感染HR-HPV人群;②TCT与HPV结合对检测宫颈癌前病变有相当积极的意义。
Objective: To understand the main types, age distribution and infection status of high-risk human papillomavims (HR-HPV) infection in some women in Zunyi City and to explore the clinical application of HPV DNA test combined with liquid-based cytology in the diagnosis of cervical lesions significance. Methods: Totally 1786 women tested 16 HR-HPV subtypes with human papillomavirus nucleic acid amplification typing test kit and performed TlfinPrep liquid based cytology test (TCT) And / or HR-HPV were positive for further pathological examination. Results: ①HR-HPV-positive patients accounted for 21.1% with 376 cases, abnormal cytology results were 342 cases (19.15%), atypical squamous cell carcinoma (ASCUS) and LSIL Abnormal cytology results were 73.1% of the two most common; ② For TCT and (or) HR-HPV were positive colposcopy biopsies, with the higher level of TCT, biopsy colposcopy coincide The higher the rate. The positive rate of TCT, HR-HPV and the positive rate of LSIL between the two groups had no significant difference among the three groups; ③ The HPV infection rate of the young and active women in the normal population was higher (P <0.05); ④The positive rate of HPV16 Type infection rate (P <0.05), followed by HPV51 type and 18 type. Conclusion: (1) Female genital tract HR-HPV infection is one of the major risk factors of cervical cancer and cervical intraepithelial neoplasm (CIN), suggesting that the prevention and treatment of cervical cancer should focus on prevention of HPV infection and HPV infection Infection screening and close monitoring of infected HR-HPV populations; ②TTCT combined with HPV detection of cervical precancerous lesions have a very positive significance.