摘要
目的 通过对 2 0 6 3例临床诊断为尖锐湿疣活检组织的形态学观察 ,并应用原位杂交检测方法分析尖锐湿疣组织中低危人乳头状瘤病毒 (HPV)感染情况和组织形态学改变之间的关系 ,首次对挖空细胞在尖锐湿疣组织病理学诊断上所起的作用进行评价。方法 收集 2 0 6 3例活检组织标本 ,①根据组织病理学诊断尖锐湿疣的标准分为2组 ,尖锐湿疣组 140 9例 ,非尖锐湿疣组 6 5 4例。应用原位杂交方法检测组织中低危人乳头状瘤病毒感染情况和形态学改变。②以挖空细胞为诊断标准 ,将 2 0 6 3例活检标本分为“挖空细胞组”112 9例与“非挖空细胞组”934例 ,并将结果与病理诊断标准进行比较分析。结果 原位杂交阳性信号主要位于挖空细胞的细胞核中 ,在 2 0 6 3例中有146 6例阳性 ,阳性率 71.0 6 % ,其中尖锐湿疣组 140 9例有 134 1例阳性 ,阳性率 95 .17% ;非尖锐湿疣组 6 5 4例有 12 5例阳性 ,阳性率 19.11%。以挖空细胞作为诊断标准 ,其灵敏度为 77.93% ,特异度 95 .2 6 % ,阳性预告值 97.2 5 % ,阴性预告值 6 6 .70 % ,阳性似然比 81.81% ,阴性似然比 2 3.17% ,漏诊率 2 2 .0 7% ,误诊率 4.74%。结论 低危HPV -6 / 11病毒感染是尖锐湿疣形成的主要病原因素 ,棘层中的挖空细胞是诊断尖锐湿疣的重要组织学依据之一 ,
Objective To evaluate the role of koilocytes in the diagnosis of condyloma acumunatum (CA) and the correlation of human papillomavirus (HPV) infection with the histopathologic alterations. Methods 2063 cases of formalin-fixed and paraffin-embedded biopsies were divided into two groups, CA and non-CA, based on the histopathological criteria. HPV- 6/11 DNA was detected by in situ hybridization in all the specimens. According to the presence or absence of koilocytes in the tissues, two groups were redefined as koilocyte and non-koilocyte groups, and then compared with the histopathological diagnosis. Results HPV-6/11 DNA was detected in 1466 of 2063 cases (71 6%). The positive rates of the virus infection in CA and non-CA groups were 95 17% and 19 11% respectively. Most of HPV positive cells were koilocytes. By using koilocytes as a diagnostic marker for CA, its sensitivity was 77 93% and specificity 95 26%, positive and negative predictive values were 97 25% and 66 70%, positive and negative likelihood rates were 81 81% and 23 17%, and, under-diagnosis and misdiagnosis rates were 22 07% and 4 74%, respectively. Conclusions The results indicate that CA is significantly correlated with low-risk HPV infection and koilocyte is the most important marker for the diagnosis.
出处
《诊断病理学杂志》
CSCD
2000年第4期276-278,I071,共4页
Chinese Journal of Diagnostic Pathology
