检验医学 ›› 2014, Vol. 29 ›› Issue (5): 501-504.DOI: 10.3969/j.issn.1673-8640.2014.05.017

• 临床应用研究·论著 • 上一篇    下一篇

高危型HPV DNA检测负荷量及其最佳阈值在宫颈癌前病变中的应用研究

倪颖华, 施幼豪   

  1. 复旦大学附属妇产科医院检验科, 上海 200011
  • 收稿日期:2013-12-09 出版日期:2014-05-30 发布日期:2014-05-27
  • 作者简介:倪颖华, 女, 1985年生, 学士, 技师, 主要从事人乳头瘤病毒感染的检测与研究。

Application research on virus load and optimal threshold for the detection of high risk HPV DNA in cervical precancerous lesion

NI Yinghua, SHI Youhao.   

  1. Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
  • Received:2013-12-09 Online:2014-05-30 Published:2014-05-27

摘要: 目的 探讨高危型人乳头瘤病毒(HPV)DNA检测中的负荷量和最佳阈值在宫颈癌前病变中的应用。方法 检测805例非宫颈癌患者HPV DNA, 同时通过阴道镜活检进行病理学诊断。根据病理结果将患者分为正常无病变组86例、慢性宫颈炎组492例、低度鳞状上皮内病变(LSIL)组117例、高度鳞状上皮内病变(HSIL)组110例。比较各组HPV DNA阳性率, 采用受试者工作特征(ROC)曲线确定HPV DNA判断宫颈鳞状上皮内病变的最佳RLU/CO值。结果 正常无病变组、慢性宫颈炎组、LSIL组、HSIL组HPV DNA阳性率分别为20.93%、34.96%、75.21%、95.45%, 高危型HPV DNA负荷量(中位数)分别为0.355 0、0.455 0、47.41、286.68。将宫颈鳞状上皮内病变的HPV DNA负荷量从小到大数量分级, 其检测异常率分别为8.29%、24.42%、48.94%、59.66%、68.54%。根据ROC曲线结果, 判断宫颈鳞状上皮内病变的最佳RLU/CO值为3.155 0, 该值的敏感性为82.2%、特异性为73.9%、Youden指数为1.561;判断HSIL的最佳RLU/CO值为5.965 0, 该值的敏感性为92.0%、特异性为68.8%、Youden指数为1.608。结论 宫颈鳞状上皮内病变患者的高危型HPV DNA负荷量与宫颈病变的检测阳性率呈正比。适当提高最佳RLU/CO值, 能够提高检测的特异性, 降低宫颈鳞状上皮内病变的假阳性率。

关键词: 人乳头瘤病毒, 高危型, 宫颈癌前病变

Abstract: Objective To investigate the application of virus load and optimal threshold for the detection of high risk human papillomavirus(HPV) DNA in cervical precancerous lesion. Methods A total of 805 patients without cervical cancer were performed HPV DNA detection and pathological diagnosis through colposcope biopsy. According to the pathological results, the patients were classified into 86 cases without lesion, 492 cases of chronic cervicitis, 117 cases of low-grade squamous intraepithelial lesion (LSIL)and 110 cases of high-grade squamous intraepithelial lesion (HSIL). The HPV DNA positive rate in each group was compared, and the receiver operating characteristic (ROC) curve was used to determine the optimal RLU/CO value of HPV DNA in cervical squamous intraepithelial lesion. Results The positive rates of HPV DNA detection in no lesion group, chronic cervicitis group, LSIL group and HSIL group were 20.93%, 34.96%, 75.21% and 95.45%, and the virus loads (means) of high risk HPV determination results were 0.355 0, 0.455 0, 47.41 and 286.68. The testing results of cervical squamous intraepithelial lesion were ordered according to the virus loads from small to big, and the abnormal detection rates were 8.29%, 24.42%, 48.94%, 59.66% and 68.54%. According to the ROC curve, the optimal RLU/CO value of cervical squamous intraepithelial lesion was 3.155 0, the sensitivity of the point was 82.2%, while the specificity was 73.9%, and the Youden index was 1.561. The optimal RLU/CO value of HSIL was 5.965 0, the sensitivity of the point was 92.0%, while the specificity was 68.8%, and the Youden index was 1.608. Conclusions The virus load of high risk HPV DNA is directly proportional to the positive rate of cervical lesion detection. Increasing the optimal RLU/CO value properly could improve the specificity and decrease the false positivity of cervical squamous intraepithelial lesion.

Key words: Human papillomavirus, High risk, Cervical precancerous lesion

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