HPV感染与宫颈鳞状上皮内病变及宫颈癌关系探讨

Investigation for the relation between HPV infection and cervical squamous intraepithelial lesion and cervical carcinoma

目的 探讨HPV感染与宫颈上皮内病变 (SIL)及宫颈癌 (SCC)的关系。方法 宫颈脱落细胞液基标本 ,采用TCT技术和TBS方案诊断。对液基细胞学和活检均证实为SIL和SCC的 1 5 0例进行回顾性分析 ,HPV感染的依据为核周空穴细胞。所有诊断均采用双盲法进行。用免疫组化方法检测SIL和SCC中的HPV pan(广谱 )和HPV 1 8抗原。结果 液基薄层细胞学检出 1 1 4例HPV感染 ,活检组织学检出 1 0 8例。经统计学处理 ,两者阳性率差异无显著性 (P >0 .0 5 )。免疫组化检出HPV pan 1 38例 ,检出HPV 1 86 4例 ,两者阳性率差异有显著性 (P <0 .0 5 )。结论 HPV感染强烈提示SIL和SCC可能存在 ,尤其是高危型HPV与HSIL和SCC的发生密切相关。采用液基细胞学、活检和免疫组化方法 。

Objective To investigate the relation between HPV infection and cervical squamous intraepithelial lesion(SIL)and cervical squamous cell carcinoma (SCC).Method The liquid based cytologic diagnosis was performed using the Bethesda system(TBS)on the thin prep cytology test(TCT).One hundred and fifty cases diagnosed by the liquid based cytology and histopathology were analysed retrospectively and blindly.The koilocytes was the evidence for HPV infection.Paraffin embedded sections were examined for HPV pan and HPV type 18 by immunohistochemistry.Results Of these150 cases,114 cases of HPV infection were obtained the diagnoses by liquid based cytology,but 108 cases by biopsy histopathology.One hundred and thirty eight cases were detected HPV pan and 64 cases were detected HPV 18 by immunohistochemistry.Conclusion SIL and SCC could be strongly suggested by HPV infection and there was close relationship between the high risk HPV type and HSIL and SCC.Combined using liquid based cytology,biopsy histopathology and immunohistochemistry may diagnose the HPV infection effectively.