HPV is the abbreviation for Human Papillomavirus. HPV tests for HPV viruses. In general, HPV viruses can cause cervical cancer. It is only infected with the virus. The virus is high-risk and low-risk. High-risk is easy to cause lesions. Cervical cancer is associated with high-risk, so it is necessary to treat it well. There are also cases of cervicitis, which also require treatment.Basic Information
Specialist classification: urinary examination classification: vaginal secretion examination
Applicable gender: whether men and women apply fasting: not fastingTips: Do not do vaginal washing or use intravaginal drugs within the first three days of the test. Do not have sex within 24 hours and avoid menstrual period. Normal value
HPV includes HPV6, 11, 42, 43, 44 and other types, often causing benign lesions such as external genital warts including cervical intraepithelial lesions (CINI), high-risk HPV including HPV16, 18, 31, 33, 35, 39 Types 45, 51, 52, 56, 58, 59, 68, etc., are associated with the occurrence of cervical cancer and cervical intraepithelial lesions (CINII/III), especially HPV 16 and 18. It does not belong to this range and is normal.Clinical significance
After women infected with HPV, about 30%-50% of women have mild lesions of cervical epithelial cells, but most women will turn to normal within 3-4 months after virus removal, so if during this time At the same time, HPV and cytology were examined, and HPV was negative and cytology was abnormal.
Need to check the crowd: in the vaginal examination, visible superficial erosion, contact bleeding, etc.; in the middle of the leucorrhea increased, odor, irregular vaginal bleeding, persistent pain in the appendix, buttocks and thighs, bladder, In the case of rectal invasion, there may be manifestations such as urination and defecation.Precautions
Forbidden before examination: Do not do vaginal washing or use intravaginal drugs within three days, do not have sex within 24 hours, avoid menstrual period.
Requirements for inspection: Be optimistic and avoid depression, tension and depression.Inspection process
First, histopathological changes
The epidermis is papillary-like hyperplasia and the acanthosis is hypertrophic. The surface has mild keratosis and parakeratosis. The vacuolated cells are visible in the spine cells and the granular layer. The cell bodies are large, and there is a round deep-stained nucleus. The nucleus is vacuolated, lightly stained, and filaments are connected between the nuclear membrane and the serosa. It is cat-like. Cavitation cells are characteristic of genital warts and are more pronounced in the upper and upper layers of spine cells. The medium-density infiltration of the superficial vascular layer of the dermis is mainly lymphocytes, and plasma cell infiltration is also observed. The dermal papillary vessels are dilated, the nipple is widened, and the nipple is extended.
Second, the vinegar white test
Wrapped with gauze soaked in 3% to 5% acetic acid solution or applied to the surface of suspicious skin or mucous membranes. After 3 to 5 minutes, the typical condyloma acuminata will present white papules or mites. Subclinical infections appear as white patches or spots. The vinegar white test is a simple and easy method for identifying early condyloma acuminata damage and subclinical infection. It is a very useful tool for discovering subclinical infections that have not seen visible changes. The vinegar white test is simple and easy, and should be used as a routine examination method for patients with condyloma acuminata, which helps to determine the extent of the lesion and guide the treatment. However, the vinegar white test is not a specific test, and false positive results may occur on the epithelial cells after epithelial cell hyperplasia or post-traumatic injury.
Third, colposcopy (colposcopy)
The colposcope is a special magnifying glass. It is mainly used for the observation of the mucosa of the cervix and the vagina. It can be used for the examination of the vulva and vaginal epithelium. Colposcopy can amplify the cervical performance by 20 to 40 times. It is helpful for the early detection of subclinical infection of the cervical epithelium, early detection of precancerous lesions, and early diagnosis. Patients should avoid vaginal washing and sexual intercourse within 24 hours prior to the examination. A colposcopy examination of the cervix with a gauze soaked in 3% to 5% acetic acid solution for 3 minutes will help to detect subclinical infections of HPV. White patches or spots with clear boundaries should be further taken for histopathological examination. Cervical intraepithelial neoplasia (CIN) can be divided into 3 levels.
Fourth, cytological examination
It is mainly used to check the infection of HPV in women's vagina or cervical epithelium. The cells were scraped off on the test site and applied to the slides, fixed with 95% alcohol; commonly used Pap staining, the microscopic findings were divided into five grades, grade I was normal; grade II was inflammation; grade III was suspected cancer, Grade IV is highly suspicious and grade V is cancer. Class II is divided into IIa and IIb. IIa is an inflammatory cell; the IIb smear contains a little mild nuclear heterogeneous cells in addition to inflammatory cells. Cases of smear IIb should be followed up and checked regularly. To determine if there is HPV infection, specific anti-HPV antibodies are used for histochemical staining or in situ hybridization.
V. Polymerase chain reaction (PCR)
Take a sample of diseased tissue or suspicious part, extract DNA, and amplify the target DNA with specific primers. Primers can be HPV universal primers or specific primers for a certain type. The method is highly sensitive and specific, but the method should be carried out in a laboratory accredited or certified by the relevant institution.Not suitable for the crowd
Women during menstruation are not suitable for examination.Adverse reactions and risks
After infection with HPV, 20 to 30% of patients may have condyloma acuminata, which can also cause cervical lesions, including cervicitis, cervical erosion, and even cervical cancer. 70 to 80% of people do not have any sensory lesions. This is equivalent to a carrier of hepatitis B virus. It has strong self-resistance and can be multiplied by the virus, but it needs to be closely watched.