HPV16/18型原位杂交检测在子宫颈液基细胞学中的应用价值

Application Value of HPV 16/18 Detection by in Situ Hybridization in Liquid-based Thin-layer Cytology

目的:评价薄层液基细胞学及HPV16/18型原位分子杂交检测在子宫颈病变中的应用价值。方法:应用薄层液基细胞学技术及HE染色对112例患者行子宫颈脱落细胞学检查,按照TBS(theBethesda report system)细胞学分类标准分类:无上皮内病变或恶性病变(negative for introepithelia or ma-lignancy,NILM),意义不明确的非典型鳞状上皮细胞(atypical squamous cell of undetermined significance,ASC-US)、低度鳞状上皮内病变(Low-grade squamous intraepithelial lesion,LSIL)、高度鳞状上皮内病变(High-grade squamous intraepithelial lesion,HSIL),鳞状细胞癌(squamous cell carcinoma,SCC)。同时应用原位分子杂交方法对样本进行HPV16/18型检测。结果:①在112例细胞涂片中,NILM:16例(14.3%);炎症病变:26例(23.2%);ASC-US:44例(39.3%);LSIL:25例(22.3%);HSIL:1例(0.89%);②112例细胞涂片中HPV16/18型阳性率随着子宫颈病变加重而增高,NILM及炎症、ASC-US、LSIL及HSIL各组间相比,NILM及炎症病变组与LSIL及HSIL组之间表达差异有统计学意义(P<0.05);③对5例细胞学HPV16/18型胞浆阳性病例的子宫颈活检标本进行HPV原位杂交对照检查,结果显示细胞核均呈阳性。结论:子宫颈液基细胞学联合HPV16/18型原位分子杂交检测有助于发现HPV感染引起的子宫颈病变;HPV16/18型细胞涂片中胞浆阳性染色,可作为细胞学检查HPV阳性的判定指标。

Objective： To evaluate the application value of liquid-based cytology and HPV 16/18 detection by in situ hybridization in cervical lesions.Methods： 112 cases were examined with liquid-based thin-layer cytology and stained with HE.According to the classification standard of TBS,the cervical lesions were divided into negative for intraepithelial or malignancy（NILM）;atypical squamous cell of undetermined significance（ASC-US）;Low-grade squamous intraepithelial lesion（LSIL）;High-grade squamous intraepithelial lesion（HSIL） and squamous cell carcinoma（SCC）.And HPV 16/18 of 112 cases were detected by in situ hybridization.Results： ① In the 112 cases,16 cases（14.3%） were NILM;26 cases（23.2%） were inflammatory;44 cases（39.3%） were ASC-US;25 cases（22.3%） were LSIL;1 case（0.89%） was HSIL.② With the lesion aggravating,the positive rate of HPV 16/18 increased gradually.And there was a significant difference（P0.05） between NILM,inflammation and LSIL,HSIL.③ In cervical cytology,HPV 16/18 positive expression was located in cytoplasm in 5 cervical biopsy specimens.And it was also located in nucleus detected by in situ hybridization in the same specimens.Conclusions： Liquid-based cytology combining with HPV 16/18 detection by in situ hybridization is helpful for testing cervical lesion;cytoplasm HPV 16/18 positive staining may be used as a positive assessment marker in cervical cytology.