宫颈不典型鳞状上皮细胞患者的阴道镜检查及HPV-DNA检测结果分析

Analysis of vaginoscopy and HPV-DNA detection results of patients diagnosed with cervical atypical squamous cells

目的:探讨性质未定的宫颈不典型鳞状上皮细胞(AS-CUS)阴道镜检查及HPV-DNA检测的临床价值。方法:对86例宫颈细胞学诊断为AS-CUS的患者进行高危HPV-DNA检测和电子阴道镜检查及多点活检并复查、随访2年。结果:86例宫颈病理结果:炎症28例(32.6%),CINⅠ41例(47.7%),CINⅡ11例(12.8%),CINⅢ5例(5.8%),原位癌1例(1.2%),阴道镜检查高度CIN患者Reid评分3分或以上者占100.0%(17/17),低度CIN或以下患者Reid评分3分或以上者仅占14.6%(6/41),两者差异有统计学意义(P<0.01)。高度CIN患者的高危HPV阳性率为94.1%(16/17),低度CIN或以下患者的高危HPV阳性率为63.4%(26/41),两者差异有统计学意义(P<0.05)。结论:AS-CUS的患者中潜存着宫颈高级别的CIN病变及宫颈早期浸润癌,宫颈高度CIN病变与高危HPV感染密切相关。正确评估阴道镜图像及在阴道镜下定位活检准确性高,可避免漏诊。

Objective： To investigate the clinical value of the undecided nature of cervical atypical squamous cells （AS - CUS） vaginoscopy and HPV - DNA detection. Methods： The high - risk HPV - DNA testing and line electronic vaginoscopy and multi - point bi- opsy were carried out on the 86 cervical cytology diagnosis of AS - CUS patients who were followed up for 2 years~ Results： The results of the 86 cases of cervical pathology were as follow： inflammation, 28 cases （32. 5% ）, CIN Ⅰ 41 cases （47.7%）, CIN Ⅱ 11 cases （ 12. 8% ）, CIN Ⅲ 5 cases （5.8%）, carcinoma in situ 1 case （1.2%） . Vaginoscopy in patients with a high degree of CIN and Reid score was 3 or above, which accounted for 100% （ 17/17）, while patients with low - grade CIN or below and Reid score 3 or higher only 14, 6% （6 / 41 ） The difference was statistically significant （P 〈 0. 01 ） . A high degree of high - risk HPV - positive CIN patients was 94. 1% （ 16/17 ）, while low CIN or less low - risk HPV - positive patients was 63.4% （ 26/41 ）, the difference was statistically significant （ P 〈 0. 05 ） Conclusion： Patients with ASCUS have latent high -level cervical lesions CIN and early invasive cervical, and the high degree of CIN lesions and high - risk cervical HPV infection is closely related. Correct assessment of the image and vaginoscopy biopsy with high accuracy can avoid misdiagnosis.