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目的探讨高危型人乳头瘤病毒(human papilloma virus,HPV)检测作为宫颈癌及癌前病变初筛手段的可行性。方法选取2011年5月至2012年5月深圳市香蜜湖街道1 000名自愿参加宫颈癌筛查的妇女作为观察组,以高危型HPV检测作为初筛方法,阳性者进一步行液基细胞学检查(liquid-based cytology test,LCT),结果≥非典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)者行阴道镜下宫颈活检,以病理诊断为确诊标准;以同期于深圳市计划生育服务中心就诊的行联合筛查(高危型HPV+LCT)的体检妇女600名为对照,进行高级别宫颈病变及宫颈癌的人群发病率的比较分析。结果1观察组高危型HPV感染率8.80%(88/1 000)。不同文化程度分组中小学及以下、大学及以上两组感染率较高,分别为12.99%(10/77)、14.21%(27/190),与其它两组比较差异有统计学意义(P<0.05);不同年龄、职业及不同性生活年限分组中的各组感染率比较,差异无统计学意义(P>0.05)。2高危型HPV初筛组高级别宫颈病变及宫颈癌的人群发病率为1.40%(14/1 000),联合筛查组的人群发病率为1.83%(11/600),差异无统计学意义(P>0.05)。结论以高危型HPV检测作为宫颈癌人群普查的初筛手段高效、可行。
Objective To investigate the feasibility of using high-risk human papilloma virus (HPV) as a screening tool for cervical cancer and precancerous lesions. Methods From May 2011 to May 2012, 1,000 women who volunteered to participate in cervical cancer screening in Xiangmihu Street, Shenzhen City were selected as the observation group. The high-risk HPV test was used as the screening method. The positive patients were further treated with liquid-based cytology (LCT), Results ≥Associac squamous cells of undetermined significance (ASCUS) underwent colposcopic cervical biopsy, with pathological diagnosis as the diagnostic criteria; the same period in the Shenzhen Municipal Planning 600 infertility women who underwent joint screening (high-risk type HPV + LCT) at the reproductive health service center for comparative analysis of the incidence of high-grade cervical lesions and cervical cancer. Results 1 The observation group of high-risk HPV infection rate 8.80% (88/1 000). The infection rates were higher in primary and secondary schools with different educational level and below primary and secondary school respectively, accounting for 12.99% (10/77) and 14.21% (27/190) respectively, with significant difference compared with the other two groups (P < 0.05). There was no significant difference in the infection rates among different age groups, occupation groups and life span groups (P> 0.05). The incidence of high-risk HPV screening group was 1.40% (14/1 000) in high-grade cervical lesions and cervical cancer patients, and the incidence of combined screening group was 1.83% (11/600), the difference was not statistically significant (P> 0.05). Conclusion High-risk HPV testing as a primary screening method for cervical cancer screening is effective and feasible.