摘要
目的了解高危型人乳头瘤病毒（HPV）载量与宫颈病变和宫颈癌相关性，寻找导致宫颈高度病变和宫颈癌的HPV阳性分界点。方法选取2008年9月至2012年4月昆明地区妇女两万余例，用第二代杂交捕获（HCⅡ）方法检测高危型HPV—DNA，对3446例HPV阳性患者进行阴道镜下多点活检送病检，宫颈上皮内瘤变（CIN）患者以宫颈锥切术后病检结果为准，宫颈癌患者以术后病检为准，分析HPV病毒载量与宫颈病变级别和宫颈癌的相关性。结果HPV病毒载量在1～10、〉10～100、〉100—1000、〉1000～10000RLU／CO时，患CINI的OR值分别为1．00、1．387、1．879、1．563；患CINⅡ以上病变OR值分别为1．00、2．214、7．839、12．90；患宫颈癌的OR值分别为1．00、6．949、5．416、8．736。以HPV病毒载量预测高度宫颈病变时，受试者工作曲线（ROC）下面积为0．72，其中当HPV为100RLU／CO时诊断价值最大，预测高度病变的敏感度为75．6％，特异度为62．7％。结论不同HPV病毒载量引起宫颈病变级别的风险有差别，引起宫颈癌的风险没有明显差别。HPV病毒载量可作为诊断CINll以上病变的指标，载量为100RLU／CO是导致宫颈高度病变的阳性分界点。
Objective To understand the correlation of high-risk human papillomavirus( HPV) viral load and cervical lesions and cervical cancer,looking for HPV-positive cut-off point to lead high-grade cervical lesions and cervical cancer.Methods Highrisk HPV-DNA was detected in more than twenty thousand women in Kunming area by HCⅡ( secondgeneration hybrid capture) method,multiple biopsy under colposcopy sent to pathological examination of 3446 cases of HPV-positive,of CIN( cervical intraepithelial neoplasia) cases with cervical conization to inspect results,cervical cancer patients with postoperative disease inspection subject. Results It was found that of HPV viral load 1 ~ 10,> 10 ~ 100,>100 ~ 1000,> 1000 ~ 10000 RLU / CO,the risk of CIN Ⅰ was 1. 00,1. 387,1. 879,1. 563; more than CIN Ⅱ lesions was1. 00,2. 214,7. 839,12. 90,cervical cancer was 1. 00,6. 949,5. 416,8. 736; HPV viral load predicts high-grade cervical lesions,receive operating characteristic curve( ROC) area was 0. 72,which was high degree of diagnostic value,when HPV load was 100RLU / CO,the sensitivity of high-grade cervical lesions was 75. 6% and specificity was 62. 7%. Conclusion The level of risk of cervical lesions caused by different viral load,that causes cervical cancer risk no significant differences. HPV viral load can be used as indicators of diagnosis of CIN II above lesions,when load was 100RLU / CO,leading to the positive cut-off point for high-grade cervical lesions.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2013年第9期745-747,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
高危型人乳头瘤病毒
病毒载量
宫颈上皮内瘤变
宫颈癌
第二代杂交捕获
high-risk HPV
viral load
cervical intraepithelial neoplasia
cervical cancer
the second-generation hybrid capture
