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目的探讨聚合酶链式反应(PCR)反向点杂交法检测人乳头瘤病毒(HPV)分型在确定早期宫颈癌中的价值。方法选取2013年1月-2014年12月2 228例自愿参与宫颈筛查的已婚或有性生活史的女性为研究对象,采用PCR反向点杂交法检测患者宫颈分泌物中HPV感染情况及分型,并对筛查者行液基薄层细胞检测(TCT),以病理组织学诊断为金标准,对比分析PCR与TCT诊断在宫颈病变早期筛查中的应用价值。结果 2 228例受试者中HPV检出率为21.77%(485/2 228),各种类型的HPV感染率前5位依次为HPV16、HPV31、HPV58、HPV18、HPV52,其中重叠感染率为5.48%(122/2 228)。组织病理学宫颈病变阳性率为11.04%(246/2 228),TCT宫颈病变阳性率为15.53%(346/2 228)。TCT阳性患者中HPV阳性率为61.56%(213/346),病理组织学检测阳性中HPV阳性率为81.30%(200/246)。经分析可知,与PCR或TCT相比,PCR+TCT诊断灵敏性及特异性较高,差异有统计学意义(χ~2值分别为32.495、79.36,P<0.05)。结论对行TCT的患者同时行PCR反向点杂交法检查,将有助于提高TCT诊断灵敏性及特异性,对早期宫颈鳞状细胞癌诊断具有重要的价值。
Objective To investigate the value of polymerase chain reaction (PCR) reverse dot hybridization in the detection of human papillomavirus (HPV) typing in the determination of early cervical cancer. Methods From January 2013 to December 2014,228 cases of married or sexual life women who voluntarily participated in cervical screening were selected as the research objects. HPV infection in cervical secretions was detected by PCR reverse dot blot hybridization. (TCT). The histopathological diagnosis was used as the gold standard. The value of PCR and TCT in the early screening of cervical lesions was compared and analyzed. Results The detection rate of HPV in 2 228 subjects was 21.77% (485/2 228). The top five HPV infection rates were HPV16, HPV31, HPV58, HPV18 and HPV52 in sequence, of which the overlapping infection rate was 5.48 % (122/2 228). The positive rate of histopathological cervical lesions was 11.04% (246/2 228), and the positive rate of TCT cervical lesions was 15.53% (346/2 228). The positive rate of HPV in TCT positive patients was 61.56% (213/346). The positive rate of HPV in pathological examination was 81.30% (200/246). The analysis shows that compared with PCR or TCT, PCR + TCT diagnostic sensitivity and specificity higher, the difference was statistically significant (χ ~ 2 values were 32.495,79.36, P <0.05). Conclusions The simultaneous detection of TCT in patients with TCT will help to improve the sensitivity and specificity of TCT diagnosis and is of great value in the diagnosis of early cervical squamous cell carcinoma.