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Objective To determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN). Methods Cervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00),low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load 100. 00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression. Results The HR-HPV infection rate of the population was 14. 51% (2515/17 334). 100. 00% (29/29) of SCC,97. 63% (206/211) of CIN 3,93.43% (199/213) of CIN 2,75.04% (421/ 561) of CIN 1 and 10. 17% (1660/16 320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC,CIN 3,CIN 2,CIN I and normal were 320. 85,158. 05, 143. 70,125.34 and 9. 64, respectively. There were significant differences among the distributions of viral loads in each lesion (X2=6190. 40,P<0. 01). The severity of CIN increased with the viral load (X2=5493. 35 ,P<0. 01). Compared with the risks of CINs in HR-HPV negative population,the risks of CINs in low,moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9. 01 (6. 31 -12. 87), 24.96(18.23 -34. 17) and 68.42(51.40 -91.08); CIN 2:26.44(12.07 -57.95),98. 53 (49. 54 -195.98) and 322. 88(168.62 -618. 27) ; CIN 3 + : 72. 89(24.02 -221.18) ; 343. 58(121.81 -969.09) Was 3115.05,2413.95 and 3098.57, respectively. P<0.01) . In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95%CI):<35: 4. 71(1.23-18.09) and 15.06(4.40-51.49); 35-: 4.01 (1.62-9.90) and 14.09(6. 15 -32.28); 40-: 3.06(1.52 -6. 16) and 7.78(4.05 -14.95); ≥45: 3. 50(1.36 -9. 01) and 7. 57 (3. 13 -18. 30)], and there was a positive correlation between the risk of CIN 2 + and the viral load (Xtrend2was 51. 33,66. 28,53. 64 and 51.00,respectively. P<0. 01). The risk of CIN 2 + was highest among the women aged 40 -with high viral load [0R(95% CI):2.02 (1.15 -3. 52)]. Conclusion There is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3,and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively. 相似文献
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计算机辅助宫颈细胞学对妊娠和产后妇女检查的意义 总被引:1,自引:0,他引:1
目的 评价CCT对妊娠和产后4个月内妇女的普查效果。方法 将1146例宫颈涂片常规巴氏染色后,采用Papnet全自动电脑扫描和诊断系统行细胞学筛检,按TBS诊断分类标准诊断。结果 感染性疾病检出率为8.2%;上皮细胞异常检出率为6.3%;其中宫颈上皮内瘤变(CIN)检出率1.7%;人乳头瘤病毒(HPV)检出率为2.2%;发现2例原位癌。结论 CCT对妊娠和产妇的筛检以及围生期病人的监测和管理有积极 相似文献
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[目的]研究轻度宫颈上皮内瘤变(CIN1)的转归,并探索p16基因甲基化能否成为预测其预后的生物学指标。[方法]以2002年山西省阳城县人群子宫颈癌筛查发现的CIN1患者和宫颈正常者为研究对象,抽取所有的CIN1共139例,同时随机抽取正常120例.运用甲基化特异性PCR(MS—PCR)-DH-PLC组合检测技术对基线病理蜡块进行p16基因甲基化检测。追踪随访CIN1患者6年,观察病变的转归,并评价p16基因甲基化对CIN1病变进展的危险性。[结果]随访6年后,CIN1病变逆转、持续和进展的比例分别为70.3%、13.2%和16.5%。对基线标本进行p16基因甲基化检测,CIN1组的甲基化率(24.2%)高于正常组(17.6%),但差别无统计学意义(x2=1.60,P=0.21);基线HPVDNA阳性组的甲基化率(23,5%)高于阴性组(15。6%),差别无统计学意义(Y2=2.01,P=-0.17)。CINl中甲基化和非甲基化组病变持续或进展的比例分别为20.0%和34.9%,差异无统计学意义(X2=2.30,P=0.13),病变预后与p16基因甲基化状态无明显关联(RR=0.57,0.26~1.24)。[结论]经过6年随访,约有三分之二的CIN1逆转,仅有三分之一的病变维持原状或发生进展。尚不能证明CIN1病变进展与p16基因甲基化有关,该指标不能用于预测CIN1的预后。 相似文献
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山西省阳城县妇女人乳头瘤病毒感染的危险因素分析 总被引:5,自引:0,他引:5
目的探讨影响我国子宫颈癌高发区人乳头瘤病毒感染的因素,为人乳头瘤病毒感染和子宫颈癌的防治工作提供依据.方法采用横断面调查法对山西省阳城县子宫颈癌筛查结果进行比较研究.将采集的子宫颈细胞应用第二代杂交捕获试验进行HPV DNA检测,可检测13种高危型HPV脱氧核糖核酸(DNA),以≥2.0 pg/ml作为阳性指标.资料应用VFP软件进行录入和整理,用χ2检验和非条件Logistic回归模型分析危险因素与子宫颈癌的关系.结果 3 233名完成了调查表和HPV检测的妇女符合本次研究的要求,各性生活持续年龄段HPV感染率差别无显著性(χ2=6.35,P=0.50).单因素分析显示与HPV感染相关的因素有婚外性行为、结婚次数(>1/1)、子宫颈糜烂、息肉、尿路感染和阴道滴虫,OR分别为1.69(1.38~2.06)、1.66(1.19~2.31)、1.41(1.08~1.84)、1.24(1.05~1.46)、1.57(1.20~2.07)、1.26(1.04~1.52).HPV感染的危险度比值比随性伴侣数增高呈增高趋势,与1个性伴侣相比,2、3和>3个的危险度比值比分别为1.37(1.08~1.74)、1.55(1.03~2.34)和1.66(1.19~2.31).多因素非条件Logistic回归分析结果表明,婚外性行为和尿路感染与HPV感染差异有显著性,调整年龄后依然存在差异.结论 HPV感染的预防应放在进入性生活的各段年龄,HPV感染与婚外性行为相关,尿路感染史对HPV感染有影响. 相似文献
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免疫细胞化学和DNA图像定量分析在良恶性浆膜腔积液鉴别诊断中的应用 总被引:2,自引:0,他引:2
目的:分析B72.3、Ber-EP4和Calretinin抗体组与DNA图像定量分析(DNA image cytometry,DNA-ICM)结合在良恶性浆膜腔积液诊断和鉴别诊断中的应用价值.方法:选取109例浆膜腔积液标本做石蜡包埋细胞块切片免疫细胞化学(Immunocytochemistry,ICC)和ThinPrep薄片DNA-ICM分析.结果:109例浆膜腔积液中,最终诊断为79例癌性积液和25例良性积液,104例最终诊断病例中,B72.3、Ber-EP4和Calretinin抗体组及DNA-ICM的敏感性分别为88.6%和82.3%,两者结合敏感性高达96.2%.结论:B72.3、Ber-EP4和Calretinin抗体组与DNA-ICM结合能有效提高对癌细胞诊断的敏感性. 相似文献
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胸腔肿瘤非抽吸式穿刺活检2100例分析 总被引:2,自引:0,他引:2
目的 总结用秦氏细切割穿刺针,为胸部可疑肿瘤患者行穿刺活检,探讨其效果及并发症.方法 在B超或模拟机、CT扫描定位,常规消毒、局麻下穿刺,涂片95%酒精固定或2%福尔马林固定,离心作病理检查.结果 胸膜、纵隔、肺部肿块共2100例,阳性确诊率分别为87.7%,82.1%和80.1%,平均阳性诊断率为81.1%.气胸及咯血并发症分别为1.4%和0.9%,并发症主要发生在肺穿刺患者中.胸膜、纵隔没有出现并发症.结论 该针的优点是操作简单,不用负压抽吸,操作时间短,取材容易,成功率高,损伤小,成功率、并发症与操作熟练程度相关. 相似文献
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分子生物学研究显示食管癌的发生发展过程中有许多基因及蛋白发生改变.与食管癌癌前病变相关的分子事件主要有p53基因突变及蛋白的过表达、一些基因位点的杂合性丢失及DNA甲基化及一些染色体非整倍体的出现;与食管癌治疗及预后密切相关的生物标志物主要有P53蛋白、表皮生长因子受体(EGFR)、趋化因子受体-4(CXCR-4)等. 相似文献
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Objective To determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN). Methods Cervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00),low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load 100. 00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression. Results The HR-HPV infection rate of the population was 14. 51% (2515/17 334). 100. 00% (29/29) of SCC,97. 63% (206/211) of CIN 3,93.43% (199/213) of CIN 2,75.04% (421/ 561) of CIN 1 and 10. 17% (1660/16 320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC,CIN 3,CIN 2,CIN I and normal were 320. 85,158. 05, 143. 70,125.34 and 9. 64, respectively. There were significant differences among the distributions of viral loads in each lesion (X2=6190. 40,P<0. 01). The severity of CIN increased with the viral load (X2=5493. 35 ,P<0. 01). Compared with the risks of CINs in HR-HPV negative population,the risks of CINs in low,moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9. 01 (6. 31 -12. 87), 24.96(18.23 -34. 17) and 68.42(51.40 -91.08); CIN 2:26.44(12.07 -57.95),98. 53 (49. 54 -195.98) and 322. 88(168.62 -618. 27) ; CIN 3 + : 72. 89(24.02 -221.18) ; 343. 58(121.81 -969.09) Was 3115.05,2413.95 and 3098.57, respectively. P<0.01) . In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95%CI):<35: 4. 71(1.23-18.09) and 15.06(4.40-51.49); 35-: 4.01 (1.62-9.90) and 14.09(6. 15 -32.28); 40-: 3.06(1.52 -6. 16) and 7.78(4.05 -14.95); ≥45: 3. 50(1.36 -9. 01) and 7. 57 (3. 13 -18. 30)], and there was a positive correlation between the risk of CIN 2 + and the viral load (Xtrend2was 51. 33,66. 28,53. 64 and 51.00,respectively. P<0. 01). The risk of CIN 2 + was highest among the women aged 40 -with high viral load [0R(95% CI):2.02 (1.15 -3. 52)]. Conclusion There is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3,and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively. 相似文献