国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (4): 347-350.

• 专家论坛 • 上一篇    下一篇

宫颈癌筛查中的几个热点问题

曲芃芃   

  1. 300100 天津市中心妇产科医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-08-15 发布日期:2014-08-15

Hot Topics of Cervical Cancer Screening

QU Peng-peng   

  1. Tianjin Central Hospital of Gynecology Obstetrics，Tianjin 300100，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-08-15 Online:2014-08-15

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摘要： 宫颈癌是可预防、早期可治愈的，应针对不同地区、不同人群选择不同的筛查方案。以细胞学为基础的宫颈癌筛查使宫颈癌的发病率大幅下降。然而，细胞学筛查能发现高级别宫颈癌前病变和宫颈癌的敏感度有限。在确认人乳头瘤病毒（ＨＰＶ）是浸润性宫颈癌的原因后，ＨＰＶ－ＤＮＡ检测被引入宫颈癌筛查，使得筛查策略发生了变化，初筛方案：细胞学为基础的筛查→ＨＰＶ为基础的筛查或联合筛查→ＨＰＶ１６/１８分型检测为基础的筛查。虽然ＨＰＶ检测敏感度高，特异度和阳性预测值却很有限，且并非所有ＨＰＶ１６/１８阳性者都会发生宫颈癌前病变和宫颈癌，生物标记物的应用有助于克服这一缺陷。

关键词: 宫颈肿瘤, 普查, 乳头状瘤病毒科, 生物学标记

Abstract: Cervical cancer is preventable and curable in early stage. Different screening strategy should be chosen in different region and population. Cytology-based world-wide cervical cancer screening has led to a substantial reduction of the incidence of cervical cancer. However, the sensitivity of cytology for the detection of high-grade precursor lesions or cervical cancer is limited. After human papillomavirus （HPV） was identified as a cause of invasive cervical cancer, HPV DNA testing was developed to screen for the disease, screening strategies has changed（primary screening：cytology-based→HPV-based or Co-testing→HPV16/18 genotyping）. Although HPV testing is sensitive, it has poor specificity and positive predictive value, not everyone who carries HPV 16 or 18 develops CIN or cancer. This weakness could be overcome by application of biomarkers.

Key words: Uterine cervical neoplasms, Mass screening, Papillomaviridae, Biological markers