不典型鳞状细胞(ASC)在子宫颈病变中的诊断价值

Clinical importance of ASC in the diagnosis of cervical intraepithelial neoplasia

目的:探讨不典型鳞状细胞(ASC)在子宫颈病变中的诊断价值。方法:对TCT诊断为不典型鳞状细胞(ASC)336例患者同时行HC2-HPV-DNA检测及阴道镜下活组织检查。结果:炎性反应152例(45.2%),HPV感染86例(25.6%),轻度不典型增生(CINⅠ)29例(8.6%),中度不典型增生(CINⅡ)35例(10.4%),重度不典型增生(CINⅢ)28例(8.3%),宫颈癌6例(1.8%)。ASC-H与ASC-US相比,宫颈HPV感染以上病变及HC2-HPV-DNA阳性率明显增高,差异有统计学意义(P<0.01)。ASC-US中,HC2-HPV-DNA阳性者,宫颈HPV感染及CIN发生率明显增高,差异有统计学意义(P<0.01)。结论:对不典型鳞状细胞,属意义不明者(ASC-US),应常规行HC2-HPV-DNA检测,如HC2-HPV-DNA阳性者,应进一步行阴道镜下宫颈活检。对不典型鳞状细胞,未能除外高度上皮内病变者(ASC-H),应予高度重视,行阴道镜下宫颈活检,以提高宫颈癌及CIN的检测率。

Objective To investigate the significance of ASC in cervical intraepithelial neoplasia. Method HC2 - HPV - DNA as well as eolposcopy was applied on 336 cases with the diagnosis of ASC by TCT. Results 152 cases （45. 2% ） were found to be inflammation re- action,86 cases（25. 6% ） with HPV infection,29 cases （8. 6% ）with CIN Ⅰ, 35 cases （10. 4% ）with CIN Ⅱ ,28 cases （8. 3% ）with CIN Ⅲ,6 cases （1.8%） with cervical carcinoma. Patients with ASC -H showed higher HC2 -HPV -DNA positive rate,with statistically sig- nificance. Conclusion In order to improve the diagnosis of cervical carcinoma and CIN, patients of ASCUC in cervical smear examination should routinely apply HC2 - HPV - DNA test. If a positive result was confirmed, colposcopy and biopsy should be taken as a further exami- nation. Those of ASC - H should be highly emphasized and undertake colposcopy and biopsy.