293例宫颈细胞学ASCUS临床及病理分析

Clinical and pathology results analysis of 293 cases of cervical atypical squamous cells of undertermined significance

目的分析宫颈液基薄层细胞学TCT检测结果为未有明确意义的不典型鳞状上皮细胞(ASCUS)患者的临床与病理结果,探讨其临床意义及处理方式。方法回顾性分析2012年1～6月在我院接受宫颈液基薄层细胞学TCT检查并报告为ASCUS的293例患者,同时进行13种高危型HPV-DNA检测及阴道镜评估与镜下活检。结果在293例ASCUS患者中,高危型HPV-DNA检测阳性235例(80.20%),阴性58例(19.80%);经组织病理学证实:高级别CIN24例,宫颈癌1例,湿疣19例,CIN1和宫颈炎分别为62例、187例;HPV阳性组CIN检出率高于阴性组,两组比较差异有统计学意义(P<0.05);阴道镜检查与病理结果符合率为57.62%。结论宫颈细胞学报告为ASCUS患者,其组织病理活检结果差异大,应引起重视;HPV检测及阴道镜评估、活检可以进一步帮助明确诊断,并可为患者提供合理有效的处理方案。

Objective To explore the clinical significance and treatment principles of cervical ASCUS. Methods 293 cases of cervical ASCUS were performed by both the Hybrid Capture II （HC-II） assay for detecting 13 types of high-risk HPV-DNA and colposcopic biopsy test from January to June 2012, then analysis the clinical and pathology results. Results Of the 293 cases, the positive rate of 13 types of high-risk HPV-DNA was 80.20% （235/293）, negative rate was 19.80%（58/293）. Among them, 24 cases were high grade CIN, 1 case squamous cell carcinoma, 19 cases of simple condyloma lesions, 62 cases of CIN 1 and 187 cases of inflammation respectively; Detection rate of CIN in HPV-DNA positive group （80/235） was higher than that in negative group （7/58）. There was statistical significance between the positive group of HPV-DNA and the negative group （P 〈 0.05）. The diagnostic accordance rate of colposcopy results and pathological biopsy results was 57.62%. Conclusion For the patients with cervical ASCUS, because of the biopsy results in changes is larger, more attention should be paid to. HPV-DNA detection and colposcopy assessment, pathology biopsy may be helpful for the diagnosis and can provide a reasonable and effective treatment scheme for patients.