| 王桂清,黄久仪.脑血管血液动力学检测在卒中预防中的应用[J].Chinese journal of Epidemiology,2002,23(4):308-311 |
| 脑血管血液动力学检测在卒中预防中的应用 |
| Study of the association between human papillomavirus infection and cervical cancer in Xiangyuan coumty, |
| Received:November 19, 2001 |
| DOI： |
| KeyWord: 宫颈肿瘤 人乳头状瘤病毒 盲法 |
| English Key Word: Cervical neoplasm Human papillomavirus Blinded |
| FundProject:国家“八五”科技攻关课题 (859150102) ;国家自然科学基金(39370612);上海市科委科技发展基金 (934113060,944912014,984419014,004119006) |
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| Abstract: |
| 大众预防和高危人群预防是脑卒中的一级预防策略,但对于医疗资源尚不丰富的我国,科学的高危人群预防策略,在现阶段能获得更好的成本效果。高危人群预防策略的效果取决于敏感而特异的筛检方法和有效的干预手段。目前国内外尚缺乏便于在人群中实施并能够准确识别人群中卒中高危个体的检测手段和方法,干预措施除积极控制危险因素和服用抗血小板、抗凝药物外目前未见有其他突破性进展。 |
| English Abstract: |
| Objective To investigate human papillomavirus (HPV) prevalence in the high incidence areas of cervical cancer in Shanxi and to study the association between HPV infection and cervical cancer. Methods Cells exfoliated from cervix (collected by clinician) and from vagina (collected by subject herself) of 1997 women aged 35 45 from Xiangyuan county, Shanxi province were analyzed blindly by Hybrid Capture Assay (HC Ⅱ), which could detect 13 HPV types of high risk. Unconditional logistic regression model was used to analyze the relation between HPV and cervical cancer/cervical intraepithelial neoplasia (CIN). Kappa coefficient was used to compare the agreement of the two tests. Results HPV DNA detection rate in the population was 20.8 % while HPV infection rates increased with the seriousness of cervical lesions (χ 2= 444.04, P = 0.000 ). Rates of the two groups (35 39 and 40 45) had no significant difference ( 20.9 %∶ 20.6 %,χ 2= 0.03, P = 0.86 ). Unconditional logistic regression analysis showed, when comparing with the normal subjects, the risk odds ratio of HPV infection with cervical cancer/high grade CIN and low grade CIN were 254.2 and 26.4 respectively, with attributable risk proportions ( ARP ) 98.1 % and 83.6 % respectively. The sensitivity of self collected vaginal swabs assayed for HPV DNA was lower than that of clinician collected cervical samples assayed for HPV DNA (84%∶98%,χ 2= 5.92, P = 0.015 ). No significant difference in specificity was seen between them (86%∶85%,χ 2= 0.00, P = 0.997 ) and there was fair agreement between the two tests (kappa= 0.74 ). Conclusion High risk HPV infection in female genital tract was the major risk factor of cervical cancer and CIN in the areas. Prevention and control of cervical cancer should be focused on avoiding HPV infection, screening women for HPV infection and monitoring population infected by high risk HPV. Self collected vaginal swabs assayed for HPV DNA seemed a more practical method in primary screening for cervical cancer. |
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