高危型HPV DNA检测在ASC-US分流中的作用

The effect of high-risk HPV DNA testing in the shunt of ASC-US

目的:评价高危型HPV DNA检测在ASC-US分流中的作用,探讨液基细胞学检查为ASC-US患者的最佳管理方案。方法:选取2007年1月至2009年12月在唐山市妇幼保健院行液基细胞学检查报告为ASC-US、具有完整随访记录的800例病例进行回顾性分析,其中400例进行高危型HPV DNA检测,阳性者行阴道镜下多点活检,阴性者定期随访;400例进行重复细胞学检查,6个月后复查液基细胞学,报告ASC-US及以上病变者行阴道镜下多点活检,阴性者12个月后再次复查液基细胞学。比较两种方法的病变检出率。结果:高危型HPV DNA检测阳性254例,其中162例经活检证实存在CIN病变,单次检测病变检出率为40.5%。定期细胞学复查者中,174例再次报告ASC-US,其中118例经活检证实存在CIN;23例在12个月后的第二次复查中再次报告ASC-US,其中14例经活检证实存在CIN。重复细胞学检查组的病变检出率(33.0%)显著低于高危型HPV DNA检测组(P<0.05)。结论:高危型HPV DNA检测在对ASC-US患者的管理中能够迅速有效地发现病变,较重复细胞学检查有明显的优势。

Objective：To evaluate the effect of high-risk HPV DNA testing in the shunt of ASC-US,and investigate the best management program of patients with ASC-US.Methods：We selected 800 cases from Jan.2007 to Dec.2009 in Maternal and Child Health Hospital of Tangshan which the line liquid-based cytology were reported ASC-US and had complete follow-up records.These cases were analyzed retrospectively.400 cases received high-risk HPV DNA testing,positive cases carried out colposcopic multiple punch biopsy,and regular follow-up in the negative.Another 400 cases repeated liquid-based cytology testing,after 6 months,the cases reported of ASC-US and above lesions carried out colposcopic multiple punch biopsy,while negative cases re-reviewed liquid-based cytology testing after 12 months.Compared of detection rate two methods.Results：Positive patients were 254 cases in high-risk HPV DNA detection,of which 162 patients with biopsy were confirmed the presence of CIN.Regular cytology review group had 174 cases which reported ASC-US again,of which 118 cases with biopsy were confirmed the presence of CIN.23 cases were reported the ASC-US once again in the second recheck after 12 months,among the total 23 cases,14 patients with biopsy were confirmed the existence of CIN.Conclusion：High-risk type HPV DNA testing could find lesions quickly and effectively in the management of patients with ASC-US and had signaficant advantage compared with repeat cytology detection.