液基细胞学联合HPV分型检测在妊娠合并宫颈上皮内瘤变患者的应用

Liquid-based cytology in combination with human papilloma virus test for cervical intraepithelial neoplasia during pregnancy

目的:应用液基细胞学联合HPV分型方法检测妊娠合并宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN),初步了解此类患者中TCT及HPV感染情况与妊娠宫颈病变的关系。方法:对象为2006年1月至2012年1月确诊为妊娠合并宫颈上皮内瘤变的72例患者,初次孕期保健均进行细胞学、HPV检测,对这些临床资料进行回顾性分析研究。结果:妊娠合并CIN发生率为2.1%。72例患者中全部产前行宫颈TCT检测,HSIL为32例,LSIL为40例,56例于产前保健时检测HPV,其中48例(85.7%)为阳性结果,32例为HPV16型单独或混合感染。72例孕期保健时行阴道镜活检病理诊断CINⅠ16例、CINⅡ16例、CINⅢ40例。结论:液基细胞学联合HPV分型检测在妊娠合并宫颈上皮内瘤变患者的应用是安全而且有效的。在妊娠期CIN患者中HPV感染率高,且HPV16型与CIN高等级病变关系密切。

Objective： The present study aimed to investigate the relationship between cervical intraepithelial neoplasia （CIN） and human papilloma virus （HPV） infection during pregnancy using liquid-based cytology and HPV test. Methods： We prospectively studied the clinical data of 72 pregnant women with CIN who were hospitalized between January 2006 and January 2012 at Tangshan Gongren Hospital. All patients underwent liquid-based thin-layer cytology technique and/or HPV test. Results： Thirty two cases, which included 16 cases each of CIN Ⅰ and Ⅱ, displayed high-grade squamous intraepithelial lesion. The other 40 cases were CIN Ⅲcharacterized by low-grade squamous intraepithelial lesion based on biopsy pathology through colposcopy. A total of 48 （85.7% ） HPV-positive cases were determined among 56 antenatal patients. Moreover, 32 of the 48 HPV-positive cases had either HPV16 infection alone or a mixture of different infection types. Conclusion： Results indicated that the CIN pregnant patients exhibited high frequency of HPV infections, and its HPV16 type is closely associated with the pathological development of high-grade lesions.