鳞状上皮细胞癌抗原在高危型HPV感染人群宫颈病变分流诊治中的应用-东南大学学报医学版

鳞状上皮细胞癌抗原在高危型HPV感染人群宫颈病变分流诊治中的应用

单位：1. 新疆医科大学附属肿瘤医院检验科, 新疆乌鲁木齐 830011;
2. 新疆医科大学附属肿瘤医院肿瘤防治研究所, 新疆乌鲁木齐 830011

分类号：R711.74

出版年·卷·期（页码）：2016·35·第六期（989-992）

摘要：

目的：探讨鳞状上皮细胞癌抗原（SCC）在高危型HPV（HR-HPV）感染人群宫颈病变分流诊治中的应用价值。方法：采用回顾性研究的方法收集1 039例妇科门诊就诊者的SCC、薄层液基细胞学检查（TCT）和HR-HPV检查的结果资料，对资料进行统计学分析。结果：HR-HPV感染者SCC含量和HPV-DNA负荷量呈正相关（r_s=0.802，P=0.012），SCC含量及阳性率随宫颈细胞病变的加深而增加。HR-HPV感染者中，TCT阳性人群SCC含量[（3.8±0.9）ng·ml^-1]与阴性人群SCC含量[（1.0±0.3）ng·ml^-1]差异有统计学意义（t=8.022，P<0.001），SCC阳性率分别是4.35%和68.97%，差异有统计学意义（χ²=103.681，P<0.001）。SCC诊断细胞学阳性的灵敏度为68.79%，特异度为95.65%，阳性预测值为94.12%，阴性预测值为75.34%。对于HR-HPV感染者，SCC阳性患者存在细胞学病变的可能性是SCC阴性者的48.889倍。结论：SCC可以为HR-HPV阳性而细胞学阴性的就诊者的分流诊治提供参考意见。

Objective: To evaluate the value of squamous cell carcinoma antigen(SCC)for shunting screening the cervical lesions in high-risk type HPV(HR-HPV) infected women. Methods: SCC, cytology(TCT), and HR-HPV examination results in 1 039 cases of outpatient from gynaecology department by retrospective study were collected, then the data was statistical analyzed. Results: There was correlation between SCC content and HPV DNA load in HR-HPV infected women(r_s=0.802, P=0.012). The SCC content and positive rate increased along with the deepening of cervical cell lesions. In HR-HPV infected women, SCC content between TCT positive[(3.8±0.9) ng·ml^-1]and negative women[(1.0±0.3) ng·ml^-1]had statistical difference(t=8.022, P<0.001), the positive rate were 4.35% and 68.97%, respectively, also had statistical difference(χ²=103.681, P<0.001). The sensitivity was 68.79%, specificity was 95.65%, positive predictive value was 94.12%, negative predictive value was 75.34%, to diagnose cytology lesion with SCC in HR-HPV infection women. It was 48.889 times to detect cytology lesion in SCC positive than SCC negative women. Conclusion: SCC can provide the reference opinion in further diagnosis for the women which had HR-HPV infection but cytology normal.

参考文献：

[1] XI R,ZHANG X,CHEN X,et al.Human papillomavirus 16 infection predicts poor outcome in patients with esophageal squamous cell carcinoma[J].Onco Targets Ther,2015,8(3):573-581.
[2] SCHETTINO M T,AMMATURO F P,GRIMALDI E,et al.Persistent papillomavirus type-31 and type-45 infections predict the progression to squamous intraepithelial lesion[J].Taiwan J Obstet Gynecol,2014,53(4):494-497.
[3] 王森钰,热娜·米吉提,冯阳春,等.新疆地区汉族女性人乳头状瘤病毒基因型及感染情况分析[J].东南大学学报:医学版,2015,34(6):902-905.
[4] 李卫鹏,张蕾蕾.鳞状细胞癌抗原研究进展[J].放射免疫学杂志,2010,23(1):34-37.
[5] LI C,MA C,ZHANG W,et al.The immune function differences and high-risk human papillomavirus infection in the progress of cervical cancer[J].Eur J Gynaecol Oncol,2014,35(5):557-561.
[6] 陈军莹,姚德生.宫颈癌血清肿瘤标志物临床应用概况[J].医学综述,2015(19):3501-3504.
[7] FENG Y C,YANG J,LIU C M,et al.DNA ploidy of cervical epithelial cells should be a cure criterion of high-risk HPV infection in Xinjiang Uygur women[J].Onco Targets Ther,2015,8:827-833.
[8] 吴立芳.宫颈癌医院机会筛查结果分析[J].现代医学,2015,34(4):442-445.
[9] DASARI S,WUDAYAGIRI R,VALLURU L.Cervical cancer:Biomarkers for diagnosis and treatment[J].Clin Chim Acta,2015,445:7-11.
[10] 王静,郑群,余素飞,等.Logistic回归联合分类树CHAID法建立SCC在宫颈癌中的辅助诊断模型[J].中华检验医学杂志,2015,38(11):761-764.
[11] 冯阳春,张园,黄艳春.高危型人乳头状瘤病毒负荷量对宫颈上皮细胞DNA倍体的影响[J].中国病原生物学,2012,7(1):5-7.
[12] 倪凤慧,俞春松.HPV感染各类宫颈疾病肿瘤标志物检测的临床价值[J].放射免疫学杂志,2013,26(5):703-704.
[13] 胡静熠,吴江平.TCT与HR-HPV联合检测对宫颈癌筛查的意义[J].江苏医药,2012,38(24):2988-2990.
[14] 徐兴云,赵蔚,李桂军,等.细胞学联合人乳头瘤病毒杂交捕获检测在宫颈上皮内瘤样病变筛查中应用[J].中华医学杂志,2012,92(35):2503-2505.
[15] 何聚莲,唐盈,林佩萱,等.HPV感染者血清鳞状上皮癌抗原检测的临床意义[J].国际医药卫生导报,2013,19(19):2945-2948.

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