高危人乳头状瘤病毒检测对TCT异常的辅助作用

Auxiliary Detection of High Risk Human Papillomavirus Virus in TCT Abnormal Patients

目的:探讨高危人乳头状瘤病毒(HPV)检测对薄层液基细胞学检测(TCT)结果异常者诊断的辅助作用。方法:对139例TCT检查结果异常的[其中未明确意义的不典型鳞状细胞(ASCUS)120例,低度鳞状上皮内病变(LSIL)17例,高度鳞状上皮内病变(HSIL)2例]患者进行HPV检测、阴道镜下宫颈活检。结果:①120例TCT提示ASCUS的患者中,HSIL 28例,检出率为23.3%;HSIL中高危HPV检出25例,检出率89.3%(25/28);低危HPV阳性及HPV阴性检出3例,检出率10.7%(3/28);高危HPV阳性者中HSIL检出25例,检出率为41%(25/61);低危HPV阳性及HPV阴性患者中HSIL为5%(3/59),并且均为CINⅡ期,统计学分析显示差异显著(P<0.05)。②17例TCT检测出的LSIL患者中,HSIL 9例,检出率为52.9%,均为高危HPV阳性者。③TCT检查HSIL患者2例,HPV高危型均阳性,病检提示均为宫颈鳞状细胞癌。结论:高危HPV检测能够对TCT结果异常患者进行确诊和鉴别,从而为后期的临床处理起到很好的指导作用。

Objective. To explore the identification value of high risk human papillomavirus （HPV） test in the patients with abnormal result of thin-prep cytologic test （TCT）. Methods. HPV assay and biopsy examination were used to identify the 139 patients with abnormal TCT test, including 120 cases of atypical squamous cells of undetermined significance （ASCUS）, 17 cases of low-grade squamous intraepithelial lesion （LSIL）, and 2 cases （HSIL）. Results： Among the 120 ASCUS cases, 28 tio of 23.3%. Of the 28 HSIL patients suggested by a ratio of 89.3% （25/28）, and 3 cases were low risk of high-grade squamous intraepithelial lesion were found having cervical HSIL, with a ra- TCT, 25 were high risk HPV positive, with HPV positive and HPV negative, with a ra- tio of 10. 7% （3/28）. Among the high risk HPV positive patients, 25 cases were found with HSIL, with a ratio of 41% （25/61）. Among the low risk HPV positive and HPV negative pa- tients, only 3 cases were found with HSIL, and all were in CIN II phase, with a positive ratio of 0.05% （3/59）. The statistical analysis showed that the HSIL positive patients ratio between high risk HPV patients and low risk or negative HPV patients was significantly different （P~ 0.05）. Among the 17 LSIL patients suggested by TCT, 9 cases are diagnosed with HSIL by bi- opsy examination, with a positive ratio of 52. 9~, and all were HPV positive. Two HSIL pa- tients suggested by TCT showed positive HPV result, and biopsy examination determined the le- sion were cervical squamous cell carcinoma（CSCC）. Conclusion： High risk HPV test is of clinical value for identification and diagnosis for patients with abnormal TCT results.