高危型HPV及阴道镜检查136例ASC-US患者

Analysis Colposcopy Combines with High Risk Human Papilloma Virus Detection for 136 Patients with Atypical Squamous Cells of Undertermined Significance

目的探讨高危型HPV（HR HPV）、阴道镜在无明确诊断意义的非典型鳞状上皮细胞（ASC—US）处理中的作用。方法对液基细胞学（LCT）检测为ASC-US的136例患者，采用HC-2检测HR HPV、阴道镜下行宫颈活检。结果136例ASC—US患者，宫颈活检病理：宫颈炎80例；宫颈上皮内瘤（CIN）56例。其中CINⅠ35例、CINⅡ14例、CINⅢ5例、宫颈鳞癌（SCC）2例，其中CINⅡ及CINⅢ占33．9％。阴道镜拟诊宫颈病变76例（55．9％）．与病理诊断符合34例：其中CINⅠ25倒、CINⅡ3例、CINⅢ5例、SCC1例，符合率43．4％。HR HPV阳性者86例（63．2％），其中CINⅡ、CINⅢ共17例（19．8％）。结论HR HPV检测、阴道镜下多点活检是处理ASC—US的正确方法。

Objective The purpose of this study is to evaluate the significance of high risk human papilloma virus （HR HPV） and calposcopy in atypical squamous cells of undetermined significance （ASC-US）. Methods The study group included 136 patients diagnosed as ASC-US by liquidbased cytologic test （LCT） . HR-HPV was determined with hybrid capture Ⅱ （HC-2） in all patients, which also underwent eolposcopy and histologic evaluation of cervical biopsy. Results Among 136 patients with ASC-US, 86 cases were positive with high-risk HPV and expression of HR HPV was 63.2%. The rate of CIN and SCC in high-risk HPV positive group was detected in 52.3%, while the rate of CIN Ⅱ and CINⅢ was 19.8% . Among the 76 patients diagnosed as CIN according to eolposeopic examination, there were 33 cases＇ diagnosis consistent with pathologic diagnosis, so comparing the calposeopie results with biopsied result the consensus rate was 43.4%. The 33 patients included 25cases CINⅠ,2 cases CIN Ⅱ ,3 cases CIN Ⅲ,1 cases SCC. The pathologic diagnosis of 136 patients were 80 cases cervicitis, 35 cases CINⅠ, 14 cases CIN Ⅱ, 5 cases CINⅢ, 2 cases SCC, the rate of high grade cervical lesions （CINⅠ, CIN Ⅱ ） were 33.9%. Conclusion The biopsy under colposcopy combined with HR HPV detection were effective methods for identification and treatment in patients with ASC-US.