摘要
目的探讨尿液人乳头瘤病毒(HPV)检测在宫颈癌筛查中的临床应用价值。方法收集2017年12月1日至2018年3月31日首都医科大学附属北京妇产医院门诊行阴道镜检查的498例患者的尿液标本及宫颈脱落细胞标本,分析尿液和宫颈标本用于检测HPV的一致性及尿液标本的灵敏度和特异度。结果宫颈标本中HPV阳性率为83.73%(417/498),尿液标本中HPV的阳性率为79.12%(394/498)。在23种HPV分型检测中,HPV16、HPV58、HPV52是常见类型,高致病性HPV18型在宫颈和尿液标本中的阳性率分别为8.43%(42/498)和8.03%(40/498)。以宫颈HPV分型为标准,尿液HPV检测的灵敏度为68.75%~100.00%,特异度为96.13%~99.80%,与宫颈HPV分型的一致性Kappa值为0.666~0.858,差异有统计学意义(P<0.001)。对于高致病性HPV16型和18型,尿液HPV检测的灵敏度为88.18%和83.33%,特异度为96.13%和98.90%,与宫颈HPV分型的一致性Kappa值分别为0.838和0.841,差异均有统计学意义(均P<0.001)。结论尿液HPV检测与宫颈HPV检测有较好的一致性,该方法简便、快速、非侵入性,适用于不具备侵入性宫颈HPV检测条件的宫颈癌早期筛查及HPV疫苗接种后的效果评价。
Objective To investigate the clinical applicative value of urine human papillomavirus(HPV)detection in cervical cancer screening.Methods The urine specimens and cervical exfoliated cell specimens of 498 patients who underwent colposcopy in the outpatient department of Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from Dec.1,2017 to Mar.31,2018 were collected.The consistency of urine and cervical specimens for HPV detection and the sensitivity and specificity of urine specimens were analyzed.Results The positive rate of HPV was 83.73%(417/498)in cervical specimens and 79.12%(394/498)in urine specimens.Among 23 types of HPV genotyping,HPV16,HPV58 and HPV52 were the common types.The positive rate of highly pathogenic HPV18 in cervical and urine samples was 8.43%(42/498)and 8.03%(40/498),respectively.Using cervical HPV typing as the standard,the sensitivity and specificity of urine HPV detection ranged from 68.75%to 100.00%,96.13%to 99.80%,and the consistency Kappa value with cervical HPV typing ranged from 0.666 to 0.858,the difference was statistically significant(P<0.001).For highly pathogenic HPV16 and 18,the sensitivity and specificity of urine HPV detection were 88.18%and 83.33%,96.13%and 98.90%,and the consistency Kappa value with cervical HPV typing was 0.838 and 0.841,respectively,the differences were statistically significant(all P<0.001).Conclusion The urine HPV detection is in good agreement with the invasive cervical HPV detection,while it′s simple,rapid and non-invasive,which is suitable for the early screening of cervical cancer without invasive cervical HPV detection conditions and the effect evaluation after HPV vaccination.
作者
宋金维
王建东
SONG Jinwei;WANG Jiandong(Department of Gynecologic Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Department of Obstetrics and Gynecology,Xicheng District Maternal and Child Health Care Hospital,Beijing 100054,China)
出处
《医学综述》
CAS
2022年第7期1435-1440,共6页
Medical Recapitulate
基金
北京市科技计划课题(Z171100000417027)。
关键词
宫颈癌筛查
尿液人乳头瘤病毒检测
人乳头瘤病毒检测
Cervical cancer screening
Urine human papillomavirus detection
Human papillomavirus detection
