HPV-DNA分型检测在ASC-US患者分层处理中的作用

Effect of HPV-DNA genotyping test in hierarchical processing of ASC-US

目的:了解HPV-DNA分型检测在意义不明确的宫颈不典型鳞状上皮细胞(ASC-US)患者分层处理中的作用。方法:260例宫颈细胞学诊断为ASC-US的患者进行HPV-DNA分型检测,同时在阴道镜下多点活检。结果:260例患者中慢性炎症168例(64.62%),其中高危HPV阳性率为38.10%(64/168);宫颈上皮内瘤变(CIN)90例(34.62%),其中高危HPV阳性率为81.11%(73/90);早期浸润癌2例(0.77%),其中高危型HPV感染2例,感染率100%。慢性炎症和CIN患者两者比较高危HPV感染阳性率差异有统计学意义(P<0.05),且两型及以上HPV感染阳性率两组差异亦有统计学意义(P<0.05)。260例中高危HPV感染排在前5位的亚型分别是HPV-16、58、52、33、31。结论:HPV-DNA分型检测在ASC-US患者分层处理中有意义,对高危HPV亚型16、58、52、33、31感染的ASC-US患者需及时干预,加强随访。

Objective： To understand the effect of human papillomavirus - DNA （ HPV - DNA） genotyping assay in hierarchical processing of atypical squamous cells of undetermined significance （ASC - US） . Methods： Two hundred and sixty patients with ASC - US underwent HPV - DNA genotyping test and multi - point biopsy under colposcope during the same period. Results： Among 260 patients, 168 patients （ 64. 62% ） were found with chronic inflammation, the positive rate of high risk HPV was 38.10% （ 64/168 ） ; 90 patients （34. 62% ） were found with cervical intraepithelial neoplasia （CIN） , the positive rate of high risk HPV was 81.11% （73/90） ; two patients （0. 77% ） were found with early invasive carcinoma, and the two patients were also found with high risk HPV infection, the infection rate was 100%. There was significant difference in the positive rate of high risk HPV infection between the patients with chronic inflammation and the patients with CIN （ P 〈 0.05 ） , and there was significant difference in the positive rate of multiple HPV infection between the two groups （P 〈0. 05） . Among 260 patients with high risk HPV infection, the top five subtypes of HPV were HPV - 16, HPV - 58, HPV - 52, HPV -33, and HPV -31. Conclusion： HPV -DNA genotyping test is significant in hierarchical processing of ASC -US; the patients with ASC - US infected by high risk HPV subtypes （ HPV - 16, HPV - 58, HPV - 52, HPV - 33, and HPV - 31 ） need timely intervention, and the follow - up should be enhanced.