无性生活状态下女性服刑人员子宫颈HPV持续感染与宫颈脱落细胞学改变的调查与分析

The investigation and analysis on the persistent infection of HPV and cytological features of cervical exfoliated cells in female prisoners on asexual state

目的了解无性生活状态下女性服刑人员子宫颈人乳头状瘤病毒（human papilloma virus，HPV）持续感染和子宫颈细胞的病变情况，为在押女性服刑人员子宫颈癌的筛查方式提供建议。方法调查310例无性生活2年以上的女性服刑人员。采用美国Digene公司杂交捕获仪（hybrid capture Ⅱ assay，HC2）检查子宫颈13种高危型HPV病毒；采用液基薄层技术对子宫颈脱落细胞进行病理检查。利用阴道镜、宫颈环形电切术（loop electrosurgical excision procedure，LEEP）对有病变者进行进一步的检查与治疗。结果在调查对象中，HPV持续感染率为14.8％，子宫颈非典型鳞状上皮细胞改变（atypical squamous cells of undeter-mined signification，ASC-US）以上病变发病率为3.3％，细胞学异常者，宫颈上皮内瘤变（cervical intra-epithelial neoplasia，CIN）病变达40％。组织病理学检查表明细胞病变与HPV阳性有很好的一致性。结论对在押女性服刑人员进行子宫颈癌筛查是降低女性整体子宫颈癌发病的有效途径之一；对子宫颈HPV阳性服刑人员可以单纯采用细胞学检查进行随访。

Objective To provide evidence for applying screening cervical cancer and screening mode to fe- male prisoners by investigating the cervical persistent infection of human papilloma virus（ HPV ） and the pathological alteration of cervical ceils. Methods 310 female prisoners who had sex life before arrested and had no sexual exposure for more than 2 years were investigated and cervical cytological screened. Hybrid Capture Ⅱ Assay （HC2） which could identify 13 high risk HPV was used to confirm cervical infection of HPV; Liquid Thin Prep was used to examine cervical cell; loop electrosurgical excision procedure（LEEP） and colposcopy were used if indicative. Results The persistent infection rate of high risk HPV was 14. 8% among the investigated prisoners; 9 cases with atypical squamous cells of undetermined significance（ASCUS） and one with high-grade squamous intraepithelial lesion （HSIL） were found. Cytological abnormality was well coincident with HPV infection. Punch biopsy showed 4 CIN cases among the mentioned 10 cases. Conclusion Screening cervical cancer among female prisoners was one of the efficiency mode to reduce invasive cervical cancer; for HPV positive prisoners, cytological follow - up might be a cost-saving mode to monitor the cervical neoplasia.