【摘要】 目的了解个旧地区妇女高危型人乳头状瘤病毒(high-risk human papillomavirus,HR-HPV)流行情况,探讨HR-HPV检测在宫颈病变筛查和预防宫颈癌中的价值。方法以个旧市妇幼保健院妇科门诊就诊患者为观察对象,进行HR-HPV检测和病理学活检,以病理学诊断为金标准,以灵敏度、特异度、准确度、约登指数、假阳性率、假阴性率等为评价指标,评价HPV检测在宫颈病变筛查中的价值。结果分析了625例筛查对象,其中宫颈病变患者99例(15.8%),HR-HPV感染者302例(48.3%)。不同级别宫颈病变与HR-HPV感染率之间呈显著性正相关(r=0.728,P<0.05)。不同级别宫颈病变患病率,与年龄、孕次、产次呈显著性正相关(P<0.05),与性交开始年龄之间呈显著性负相关(P<0.05)。妇女宫颈病变患者、HR-HPV感染者和病毒载量三项指标多因素分析结果,宫颈病变以农村妇女和多性伴者为高发人群(P<0.05);HR-HPV感染以农村妇女为高发人群(P<0.05);HR-HPV病毒载量以多次妊娠者为高发人群(P<0.05)。宫颈病变级别与HPV病毒载量中位数呈显著性正相关(P<0.05)。结论 HR-HPV检测在宫颈病变筛查中具有较高的灵敏度、特异度,在筛查宫颈病变和预防宫颈癌中具有较高的临床价值。更多还原

【Abstract】 objective To investigate the epidemic of high-risk human papillomavirus(HR-HPV) on the women in Gejiu city,and explore the value of HR-HPV DNA detection in cervical lesion screening and prophylaxis of cervical carcinoma.Methods HR-HPV detection and pathological biopsy were performed on 625 patients in out-patient department of gynecology in maternal and child health care hospital of Gejiu.According to the gold standard of histopathologic diagnosis,and sensitivity,specific degrees,precision,Youden index,false positive rate and false negative rate as evaluation index,as well,the value of HPV DNA detection in cervical lesion screening was assessed.Results Of the 625 patients,99 were identified to have cervical lesions(15.8%),and 302 were infected with HR-HPV(48.3%).There was positive correlation between different levels of cervical lesion and HR-HPV infection rate(r=0.728,P<0.05).Different levels of cervical lesion had positive correlation with patients’ age,gravidity and parity(P<0.05),and had negative correlation with the initial age of sexual intercourse(P<0.05).Multivariate statistics analysis suggested that rural women and those who had multiple sexual partners be the high risk population of cervical lesion(P<0.05).Rural women were more likely to be infected with HR-HPV(P<0.05).The levels of cervical lesion had positive correlation with HPV median(P<0.05).Conclusion HR-HPV test has good sensitivity and specificity of diagnosis in cervical lesion,and may help in better prophylaxis and treatment of cervical carcinoma更多还原