阴道镜联合HPV-DAN检测在ASCUS患者分流中的价值分析

Value analysis Oof vaginoscopy combined HPV-DAN detection in patients with ASCUS sorting

目的探讨阴道镜检查联合HPV检测在未明确诊断意义的宫颈不典型鳞状上皮细胞患者分流中的临床价值。方法 116例ASCUS患者采用第二代杂交捕获技术检测高危型人乳头瘤病毒,并行阴道镜检查及镜下多点宫颈活检。结果 116例ASCUS中检出宫颈上皮内瘤变及宫颈癌54例,其中CINⅠ32例(27.6%),CINⅡ13例(11.2%),CIN Ⅲ 7例(3.2%),原位癌1例(0.9%),早期浸润癌1例(0.9%)。高度CIN及以上级别患者阴道镜检查Reid评分在3分或以上者19例,占86.4%(19/22),低度CIN及以下级别患者阴道镜检查Reid评分在3分或以上者13例,占13.5%(13/94),两者差异有统计学意义(P<0.01)。高度CIN及以上级别患者高危型HPV阳性率为95.5%(21/22),低度CIN及以下级别患者HPV阳性率为62.8%(59/64),两者差异有统计学意义(P<0.05)。结论 ASCUS患者中不仅潜在高级别宫颈病变,也有宫颈癌可能,发现ASCUS后立即行高危型HPV病毒检测及阴道镜检查、镜下宫颈活检,可尽早发现宫颈病变,阻止其进一步发展,是有效的分流方法,值得推广应用。

Objective To explore the clinical value of sorting in women with ASCUS by vaginoscopy combined HPV-DNA testing. Methods 116 cases of ASCUS were treated by hr-HPV test（Hybrid Capture Ⅲ,parallel vaginoscopy and multi-point cervical biopsy. Results All 116 cases of ASCUS detection in cervical intraepithelial neoplasia（CIN）and cervical cancer change 54 cases,which CINI 32 cases （27.6%）,CINII 13 cases（ll.2%）,CINIII cases（3.2%）,carcinoma in situ I cases（0.9%）,early invasive carcinoma 1 cases（0.9%）.Vaginoscnpy in patients with a high degree of CIN and Reid score was 3 or above,which acount for 86.4%（19/22）,while patients with low-grade CIN or below and Reid score 3 or higher only 13.5%（13/94）,the difference was statistically signifiant（P 〈 0.01）.A high degree of high-risk HPV-positive was 95.5%（21/22）,while low CIN or less low-risk HPV-positive patients was 62.8%（59/64）,the difference was statistically signifiant （P 〈 0.05）.Conclusion In patients with potential ASCUS not only high level cervical lesions,also have early invasive cervical cancer possible,found immediately after ASCUS line high-risk type HPV virus detection and colposcopy examination,microscopically cervical biopsy,can find the early cervical lesions,to prevents its further development,is an effective sorting method,it is worth for spreading application.