两种不同杂交捕获定量技术对意义不明的非典型鳞状细胞的分流价值
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摘要
目的通过比较第三代杂交捕获技术定量分型(daltonbio hybrid capture 3, DH3)与第二代杂交捕获技术(the second generation of hybrid capture, HC2) 2种方法检测人乳头状瘤病毒(human papiloma virus,HPV)的结果,探讨DH3对意义不明的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASCUS)分流的应用价值。方法采用DH3、HC2分别检测198例昆明医科大学第二附属医院行薄层液基细胞学检测技术(Thin-Cytologic Test, TCT)检查提示ASCUS患者宫颈脱落细胞样本中的高危HPV,并行阴道镜下宫颈活检,分析DH3与HC2检测结果的符合率及对ASCUS分流的情况。结果 (1) DH3与HC2两种方法检测高危型HPV总符合率为96.43%,阳性符合率为96.67%,阴性符合率为96.30%;(2)病理检查结果:CIN1 23例(11.62%); CIN2 30例(15.15%); CIN3 3例(1.51%);宫颈癌1例(0.51%);CIN2及以上病变检出率为17.17%;(3) CIN2及以上病变共34例,全部HPV感染阳性,其中29例DH3中HPV16/18阳性。结论 DH3与HC2检测符合率高,DH3中2种高危亚型对ASCUS患者的分流具有更重要的指导意义,可作为临床上ASCUS分流的有效手段。
Objective To explore the value of daltonbio hybrid capture 3(DH3) in ASCUS shunt by comparing the second generation of hybrid capture(HC2) and DH3 detection results.Methods The high-risk HPV subtypes were detected by DH3 and HC2 respectively from ASCUS population at the Second Affiliated Hospital of Kunming Medical University hospital with 198 cases.Cervical biopsy under colposcope,The coincidence rate of DH3 and HC2 test results and the triage of ASCUS were analyzed. Results(1) The total coincidence rate of high-risk HPV detected by DH3 and HC2 was 96.43%, 96.67% positive and 96.30% negative.(2) The pathological results were as follows: CIN1, CIN2, CIN3,cervical cancer was respectively 23 cases, 30 cases,3 cases, 1 cases,.The detection rate of CIN2+ was 17.17%.(3) CIN2+ were 34 cases, all of which were positive for HPV infection, of which 29 cases were positive for hpv16/18. Conclusions The coincidence rate between DH3 and HC2 is high.The two high-risk subtypes of DH3 have more important guiding significance for the triage of ASCUS patients, and can be used as an effective method for clinical triage of ASCUS.
Objective To explore the value of daltonbio hybrid capture 3(DH3) in ASCUS shunt by comparing the second generation of hybrid capture(HC2) and DH3 detection results.Methods The high-risk HPV subtypes were detected by DH3 and HC2 respectively from ASCUS population at the Second Affiliated Hospital of Kunming Medical University hospital with 198 cases.Cervical biopsy under colposcope,The coincidence rate of DH3 and HC2 test results and the triage of ASCUS were analyzed. Results(1) The total coincidence rate of high-risk HPV detected by DH3 and HC2 was 96.43%, 96.67% positive and 96.30% negative.(2) The pathological results were as follows: CIN1, CIN2, CIN3,cervical cancer was respectively 23 cases, 30 cases,3 cases, 1 cases,.The detection rate of CIN2+ was 17.17%.(3) CIN2+ were 34 cases, all of which were positive for HPV infection, of which 29 cases were positive for hpv16/18. Conclusions The coincidence rate between DH3 and HC2 is high.The two high-risk subtypes of DH3 have more important guiding significance for the triage of ASCUS patients, and can be used as an effective method for clinical triage of ASCUS.
引文
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[10] HUH W K,AULT K A,ELMOWD K A,et al Use of primaryhigh-risk humanpapillom avrus testing for cervical cancerscreening:Interim clinical guidance[J].Gynecoloncol,2015,136:178-182.
[11]慢性感染是导致癌症发病的首要因素[J].中国社区医师,2012,28(38):24-24.
[12]王剑,王文第,蔺如,等.高危型HPV检测在宫颈ASCUS分流及随访中的应用[J].现代生物医学进展,2016,16(33):6509-6511.
[13]余育琴.宫颈细胞学ASCUS 220例诊断临床意义及处理[J].基层医学论坛,2016,20(33):4675-4676.
[14] ELISABETH B BUDAL, HANS K HAUGLAND,ROBERT SKAR,et al.Vintermyr. HPV DNA testing improves CIN2+risk stratification and detection of CIN2+in delayed triage of ASCUS and LSIL. A population-based follow-up study from Western Norway[J]. Cancer Medicine,2014,3(1):182-189.
[15]谢伟民,丁晖,吴宜林,等.直接阴道镜检查与HPVDNA检测分流在意义未明的不典型鳞状细胞处理上的效果比较[J].肿瘤学杂志,2016,22(07):600-601.
[2]刘矍,张文杰.子宫颈癌筛查方法研究现状[J].中国现代医药杂志,2012,14(8):118-120.
[3] CHEN W,ZHENG R,BAADE P D,et al. Cancer statistics in China,2015.[J]. Ca A Cancer Journalfor Clinicians,2016,66(2):115-116.
[4]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2008:301.
[5]陈永峰,张新圆.1787例HC2-HPV检测结果与宫颈病变的关系分析[J].新疆医学,2014,44(2):10-12.
[6]蔡兰兰,樊冰,张松,等.TCT与高危型HPV DNA检测在宫颈病变中的诊断价值[J].国际检验医学杂志,2011,32(9):949-950.
[7]程英.子宫颈癌筛查方法的比较研究[J].中国当代医药,2016,23(30):140-142.
[8] MONTZ F J,MONK B J,FOWLER J M,et al. Natural history of the minimally abnormal Papanicolaou smear[J].Obstetrics&Gynecology,1992,80(1):385-388.
[9]阳艳,吴绪峰,张敦兰.DNA定量分析和高危型HPVDNA检测在ASCUS分流诊断中的意义[J].肿瘤防治研究,2013,40(7):671-674.
[10] HUH W K,AULT K A,ELMOWD K A,et al Use of primaryhigh-risk humanpapillom avrus testing for cervical cancerscreening:Interim clinical guidance[J].Gynecoloncol,2015,136:178-182.
[11]慢性感染是导致癌症发病的首要因素[J].中国社区医师,2012,28(38):24-24.
[12]王剑,王文第,蔺如,等.高危型HPV检测在宫颈ASCUS分流及随访中的应用[J].现代生物医学进展,2016,16(33):6509-6511.
[13]余育琴.宫颈细胞学ASCUS 220例诊断临床意义及处理[J].基层医学论坛,2016,20(33):4675-4676.
[14] ELISABETH B BUDAL, HANS K HAUGLAND,ROBERT SKAR,et al.Vintermyr. HPV DNA testing improves CIN2+risk stratification and detection of CIN2+in delayed triage of ASCUS and LSIL. A population-based follow-up study from Western Norway[J]. Cancer Medicine,2014,3(1):182-189.
[15]谢伟民,丁晖,吴宜林,等.直接阴道镜检查与HPVDNA检测分流在意义未明的不典型鳞状细胞处理上的效果比较[J].肿瘤学杂志,2016,22(07):600-601.