Clinical significance of high-risk HPV-DNA detection combined with liquid-based cytology test in screening for cervical cancer and precancerous lesions
YOU Xiao-yan, WANG Ya-li, LIU Wen-zhi, LI Hong-juan, WANG Shu-li, CHEN Shu-mei
Department of Obstetrics and Gynecology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, China
Abstract：Objective To study the clinical value and significance of high-risk human papillomavirus (HPV) detection combined with liquid-based cytology test in screening for cervical diseases. Methods A total of 1,749 women underwent cervical cancer and precancerous lesions screening in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2015 to April 2016. HPV-DNA detection and cervical thinprep cytologic test (TCT) were performed respectively, and then the women with abnormal results of TCT were further examined by colposcope and cervical tissue biopsy. Results Among 1,749 women who underwent TCT, the abnormal rate was 12.18% (213/1,749), in which 4.80% (84/1,749) women pertained to atypical squamous cells (ASC), 3.77% (66/1,749) women to low grade squamous intraepithelial lesions (LSIL), 3.14% (55/1,749) women to high grade squamous intraepithelial lesions (HSIL) and 0.46% (8/1,749) women to squamous cell carcinoma (SCC). HPV-DNA detection indicated that 30.07% (526/1,749) women were positive for HPV-DNA. There were 112 women with TCT and HPV positive results, with the positive rate of 52.58% (112/213), of which the positive rates of ASC, LSIL, HSIL and SCC were 29.76% (25/84), 51.52% (34/66), 81.82% (45/55) and 100% (8/8) respectively. The results of colposcope and histopathology of the 213 women with abnormal TCT revealed that 58 (27.23%) cases were chronic cervicitis, 139 (65.26%) cases cervical intraepithelial neoplasia (CIN) and 16 (7.51%) cases invasive cervical carcinoma. The positive predictive values of TCT, HPV-DNA and combined detection of TCT and HPV-DNA were 72.77%, 18.06% and 84.82% respectively. There were statistically significant differences in the positive predictive value between TCT combined with HPV-DNA detection and TCT or HPV-DNA detection (P<0.05). Conclusions High-risk HPV-DNA detection and TCT are both conducive to the screening of cervical diseases, but the positive rate of TCT combined with HPV-DNA detection is higher.
尤小燕, 王雅莉, 刘文枝, 李红娟, 王淑丽, 陈淑梅. 高危型HPV联合细胞学检测在宫颈癌及癌前病变筛查中临床意义[J]. 实用预防医学, 2017, 24(8): 986-988.
YOU Xiao-yan, WANG Ya-li, LIU Wen-zhi, LI Hong-juan, WANG Shu-li, CHEN Shu-mei. Clinical significance of high-risk HPV-DNA detection combined with liquid-based cytology test in screening for cervical cancer and precancerous lesions. , 2017, 24(8): 986-988.
[1] Huh WK, Ault KA, Chelmow D, et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening:interim clinical guidance[J]. Gynecol Oncol, 2015, 136(2):178-182. [2] Halec G, Schmitt M, Dondog B, et al. Biological activity of probable/possible high‐risk human papillomavirus types in cervical cancer[J]. Int J Cancer, 2013, 132(1):63-71. [3] Haghshenas M, Golini-Moghaddam T, Rafiei A, et al. Prevalence and type distribution of high-risk human papillomavirus in patients with cervical cancer:a population-based study[J]. Infec Agents Cancer, 2013, 8(1):1. [4] 赵海鸣,冯春宇,王小敏,等.不同亚型HPV混合感染与宫颈病变严重程度关系[J].中国热带医学, 2015, 15(12):1493-1495. [5] Sun XF, Gu YQ, Wang AC, et al. Value assessment of high-risk HPV test and TCT in the screening of cervical carcinoma[J]. Chinese J Experim Clin Virol, 2013, 27(4):273-276. [6] Rijkaart DC, Berkhof J, Rozendaal L, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer:final results of the POBASCAM randomised controlled trial[J]. Lancet Oncol, 2012, 13(1):78-88. [7] McKee SJ, Bergot AS, Leggatt GR. Recent progress in vaccination against human papillomavirus‐mediated cervical cancer[J]. Rev Med Virol, 2015, 25(S1):54-71. [8] 周晖, 卢淮武, 彭永排, 等. 《 2015 年 NCCN 宫颈癌临床实践指南》 解读[J]. 中国实用妇科与产科杂志, 2015, 31(3):185-191. [9] 阳艳, 段洁, 黄燕明, 等. DNA 倍体分析和液基细胞学在宫颈病变早期筛查中的应用[J]. 实用预防医学, 2016, 23(4):444-446. [10] 张敏, 陈雪, 冯骏. 对 1302 例薄层液基细胞学检查异常病例进行 HPV-DNA 检测及组织病理学诊断结果的临床分析[J]. 中国妇幼保健, 2014, 29(25):4047-4050. [11] 张丽娜,周蓓蓓,张玢,等.HR-HPV检测与细胞学联合检查在宫颈病变筛查中的应用[J].中国现代医学杂志,2011,21(14):1666-1669. [12] 凌王芳, 王璐璐, 蒋玲玲, 等. 人乳头瘤病毒感染与宫颈病变的关系研究[J]. 实用预防医学, 2016, 23(4):464-466. [13] Hariri S, Bennett N M, Niccolai L M, et al. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States-2008-2012[J]. Vaccine, 2015, 33(13):1608-1613. [14] Rachel Skinner S, Wheeler CM, Romanowski B, et al. Progression of HPV infection to detectable cervical lesions or clearance in adult women:Analysis of the control arm of the VIVIANE study[J]. Intern J Cancer, 2016, 138(10):2428-2438. [15] Baldur-Felskov B, Dehlendorff C, Junge J, et al. Incidence of cervical lesions in Danish women before and after implementation of a national HPV vaccination program[J]. Cancer Cause Control, 2014, 25(7):915-922. [16] 刘志红, 邹艳芬. 宫颈液基细胞学检查与高危型 HPV 检测早期筛查宫颈癌前病变的对比分析[J]. 现代肿瘤医学, 2016, 24(8):1269-1271. [17] 赵超, 赵昀, 崔淑慧, 等. 子宫颈液基细胞学、高危型 HPV 及联合检测在子宫颈癌机会性筛查中的价值[J]. 中国妇产科临床杂志, 2016,17(2):119-121. [18] 刘汉忠, 杨继洲, 肖兰, 等. 液基细胞学检查联合人乳头瘤病毒基因分型检测在宫颈癌筛查中的应用[J]. 实用临床医药杂志, 2013, 17(1):44-47.
2017, Vol. 24 
