ASCUS中高级别CIN病变检出的探讨

Detection of high-grade cervical intraepithelial neoplasia in atypical squamous cells undetermined significance

目的探讨提高不典型鳞状细胞(ASCUS)中高级别宫颈上皮内瘤变(CIN)的检出率。方法对行宫颈液基细胞学检查的3352例妇女的资料进行回顾性分析。结果 3 352例妇女中,177例宫颈液基细胞学ASCUS,125例行阴道镜下宫颈活检病理学检查高级别CIN病变13例。125例中66例原位杂交法诊断高危型人乳头瘤病毒(HR-HPV)检测阳性患者,高级别CIN者11例。HR-HPV检测阴性的ASCUS患者59例,其中CIN II级及以上的患者2例,HR-HPV阳性者较HR-HPV阴性者高级别CIN的发生率高,两者差异有统计学意义(χ2=7.071,P<0.05)。结论在细胞学结果为ASCUS的患者中尚存在部分高级别CIN病变;HR-HPV DNA检测对液基细胞学检测结果为ASCUS的患者的进一步诊断具有重要的意义,有助于提高高级别CIN的诊断效率。

Objective To discuss how to improve detection of high-grade cervical intraepithelial neoplasia（CIN） in atypical squamous cells undetermined significance（ASCUS）.Methods The 3352 women with ASCUS cytologic test included in this study and were retrospectively analyzed.Results Among 3352 cases,125 cases were accepted vaginoscopy,and 13 cases were diagnosed high-grade CIN.Among125 cases,there were 66 cases was positive with High risk human papillomavirus（HR-HPV） tests,11cases were detected as high-grade CIN.2 cases were detected as high-grade CIN in 59 ASCUS cases which HR-HPV tests were negative.The difference was significant between two groups（χ2=7.071,P〈0.05）.Conclusion There are some high-grade CIN in ASCUS cytologic test;HR-HPV DNA test is an effective method for identification of high-grade cervical lesions in patients with ASCUS,and it can notably improve the sensitivity in the screening of cervical lesions.