人乳头瘤病毒在宫颈癌前病变诊断中的意义

目的用人乳头瘤病毒杂交捕获法（hc2 HPV DNA）监测宫颈癌前病变，提高诊断率。方法hc2 HPV DNA和TCT两种方法并用检测1231例宫颈外口及颈管脱落细胞。结果1231例样本中，HPV感染率34．0％，而21～40岁年龄段略高于其他年龄段；宫颈鳞状上皮正常HPV感染率23．2％。在细胞学诊断为ASC-us、ASC-h、LSIL和HSIL组中，HPV感染率依次为50．0％、58．8％、76．7％和93．3％。TCT检测：正常＋炎症1077例；asc-us 32例；ASC-h 34例；LSIL 73例，HSIL 15例。ASC-us、ASC-h、LSIL和HSIL检出率分别为2．6％、2．8％、5．9％和1．2％。统计学检验表明：HPV感染与细胞形态和结构的异常具有高度相关性（P〈0．01）。结论在宫颈鳞状上皮正常时HPV感染率最低，重度炎症时HPV感染率出现增高的趋势；当细胞形态和结构出现异常时，HPV的感染率明显增加，即HSIL〉15IL〉ASC-h〉ASC-us〉正常＋炎症。

Significance of human papillomavirus for the diagnosis precancerous cervical diseases

Objective To explore whether human papillomavirus (HPV) DNA test can raise the diagnosis rate of precancerous cervical lesions. Methods 1231 specimens of cervical desquamated cells and secretion from cervical canal were tested with hybrid capture II (hc2 HPV DNA) and thinprep cytology (TCT) methods. Results Among 1231 desquamated cervical cell specimens, the positive rate for HPV was 34.0%, with a slightly higher rate in age 21-40 groups, and for normal desquamated cells the positive rate was 23.2%. With TCT examination, 1077 specimens showed normal cells or cervicitis, 32 (2.6%) ASC-us, 34 (2.8%) ASC-h, 73 (5.9%) LSIL and 15 (1.2%) HSIL. The positive rates of HPV however, were: 50.0% of ASC-us, 58.8% of ASC-h, 76.7% of LSIL and 93.3% of HSIL, respectively. There was a high correlation (P<0.01) between HPV infection and the abnormal cell morphology and cell construction. Conclusions HPV infection was rare when desquamated cells were normal, but it tended to increase in incidence in serious inflammation. The rate of positive HPV infection was obviously increased when abnormal cellular morphology and structure were found (HSIL>LSI L>ASC-h>ASC-us > normal morphology cervicitis).