摘要
目的观察高危型人乳头瘤病毒(HR-HPV)分型、薄层液基细胞学技术(TCT)检查在高级别宫颈上皮内瘤变(CINⅡ、Ⅲ级)宫颈锥切术后预测病变残存或复发的作用。方法对105例有完整随诊临床资料并行宫颈锥切术的高级别CIN患者进行回顾性分析。结果随访2 a,术后HPV检测阳性55例中,复发25例,病变残存12例;细胞学检查阳性66例中,复发25例,病变残存11例。HPV分型检测准确性为71.5%,特异性68.0%,阳性预测值60.0%,阴性预测值95.3%;TCT检测准确性为56.4%,特异性45.0%,阳性预测值52.5%,阴性预测值75.4%。Logistic回归分析显示,术后HPV阳性、TCT阳性、HPV同一亚型持续感染是宫颈锥切术后发生病变残存和复发的高危因素;相关性分析表明,切缘阳性与HPV阳性(r=0.365)、TCT阳性(r=0.456)呈正相关(P均<0.05)。结论 HPV分型和TCT检查有助于高级别CIN患者宫颈锥切术后病变残存和复发的判断。
Objective To observe the significance of high risk HPV （HR-HPV） and TCT detections in predicting re- sidual disease or recurrence after cervical conization for high-grade cervical intraepithelial neoplasia （ CIN II - ll/）. Meth- ods A total of 105 patients with integrated clinical data of high-grade cervical intraepithelial neoplasia undergoing cervical conization were analyzed retrospectively. Results All the patients were followed up for 2 years after the operation. 55 pa- tients＇ HR-HPV detections after cervical conization were positive; among these 55 cases, 25 cases recurred and 12 cases had residual diseases. 66 patients＇ TCT detections after operation were positive; among these, 25 cases recurred and I l ca- ses had residual diseases. The accuracy was 71.5% and specificity was 68.0% in the detection of HR- HPV; positive pre- dictive value was 60.0% and negative predictive value was 95.3%. The accuracy was 56.4% and specificity was 45.0% in the detections of TCT; positive predictive value was 52.5% and negative predictive value was 75.4%. Logistic regres- sive model analysis showed that positive HR-HPV, positive TCT after cervical conization and the same isoforms of HPV were the high risk factors for residual disease or recurrence. Correlation analysis shown that positive cutting edge was obvi- ously positive correlated with positive HR-HPV （ r = 0. 365, P 〈 0.05 ） and positive TCT （ r = 0. 456, P 〈 0.05 ）. Conclu- sion Combined detection of HR- HPV and TCT are made for the criterion of predicting residual disease and recurrence af- ter cervical conization for high-grade cervical intraepithelial neoplasia.
出处
《山东医药》
CAS
2013年第16期22-24,共3页
Shandong Medical Journal
关键词
病变残留
复发
高危型人乳头瘤病毒
薄层液基细胞学技术
宫颈上皮内瘤变
宫颈锥切术
residual disease
recurrence
high risk human papillomavirus
thinprep cytologic test
cervical intraepi-thelial neoplasia
cervical conization
