82例宫颈非典型鳞状细胞患者人乳头瘤病毒感染与病理分析

Human papillomavirus infection and histological findings in 82 cases with cervical atypical squamous cells

目的:回顾性分析宫颈薄基细胞学检查(TCT)报告为非典型鳞状细胞(ASCUS)的临床意义及处理。方法:选择2011年7月～2012年8月在我院行TCT报告为宫颈ASCUS的82例患者作为研究对象,予以人乳头瘤病毒(HPV)分型检测及阴道镜检查并在其指导下行宫颈活检、病理学诊断,最后分析之间关系。结果:82例ASCUS患者中病理学诊断为炎症者32例(39.0%),低度鳞状上皮内瘤变(CINⅠ)者12例(14.6%),高度鳞状上皮内瘤变(CINⅡ～Ⅲ)者34例(41.5%),早期浸润癌者4例(4.9%)。其中宫颈炎症中HPV感染阳性者8例,占25%;CINⅠ中HPV感染阳性者为11例,占91.7%;CINⅡ～Ⅲ及早期浸润癌,全部有高危型HPV感染,阳性率为100%。结论:宫颈ASCUS患者应高度警惕宫颈癌前病变的存在,HPV分型检测可以作为其分流手段,这对ASCUS的进一步处理有重要的指导意义。

Objective ：To retrospectively asses the clinical significance of atypical squamous cells （ASC） diagnosed with liquid-based cytology （TCT） and management of this entity. Methods ： Eighty-two patients diag- nosed as atypical squamous cells of undetermined significance （ASCUS） by TCT in our hospital between July 2011 and August 2012 were enrolled in this study. The total patients underwent human papillonavirus deoxyri- bonucleic acid（HPV-DNA） detection and colposcopy guided biopsy that was confirmed pathologically. The clinical characteristics and pathological finding were retrospectively analyzed. Results ： In the 82 cases confirmed by pathology, 32 （ 39.0 % ） were chronic cervicitis, 12 （ 14.6 % ） low-grade squamous intraepithelial lesion （CIN Ⅰ ） ,34（41.5% ） high-grade squa- mous lesion （ CIN Ⅱ - CIN Ⅲ ） and 4 （ 4.9% ） early cervical invasive cancer. Of the 32 chronic cervicitis, positive HPV infection was in 8 （25%）. Eleven were positive HPV infection in 12 CIN I cases （91.7%） and 100% were highly positive HPV in CIN Ⅱ - CIN IU ca- ses. Conclusion ：Patients diagnosed as ASCUS by TCT should be highly suspected precancerosis of cervix. HPV-DNA testing is an useful screening tool for those patients and of great clinical significance in conformation of ASCUS.