高危型人乳头状瘤病毒感染检测在宫颈非典型鳞状上皮细胞妇女分流管理中的价值

The value of infection detection of HPV human papilloma virus in ASCUS women patients management

目的通过探讨人乳头状瘤病毒(HPV)感染检测在未明确诊断的宫颈非典型鳞状上皮细胞(ASCUS)妇女分流管理中的价值,以确定合理分流方法。方法收集2009年1月-2012年12月体检采用薄层液基细胞学(TCT)方法,进行宫颈癌(ICC)筛查的5480名妇女资料,对TCT检测确诊为ASCUS的152名妇女进行HC2HPV-DNA检测,按检测结果分为HPV阴性组95名和阳性组57名,所有ASCUS妇女行阴道镜检查并宫颈活检和组织病理学检查,应用SPSS16.0软件进行数据统计分析。结果 152名ASCUS妇女中高危型HPV阳性57名,占36.8%;高危型HPV阳性组中宫颈活检病理阳性率63.2%,高危型HPV阴性组中宫颈活检病理阳性率3.2%,两组活检病理阳性率比较,差异有统计学意义(P<0.01);ASCUS妇女中宫颈活检病理宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ阳性组44、13例,分别占77.2%、22.8%,阴性组95、0例,分别占100.0%、0,两组比较差异有统计学意义(P<0.05)。结论 HC2HPV-DNA检测是对宫颈细胞学ASCUS妇女最有效、简便、经济、无创的分流方法。

OBJECTIVE To investigate the clinical value of detection of human papillomavirus infection applied in atypical squamous cells of unknown significance （ASCUS）, so as to find the reasonable management about uncertain diagnosis ASCUS and decide a rational shunt method. METHODS The clinical data from 5480 cases of women receiving ASCUS detection and followed by TCT in their physical examination from Jan. 2009 to Dec. 2012 were collected, among which 152 cases who confirmed to have ASCUS by TCT test have been detected with HC2 HPV DNA. According to the result, they were separated by negative group （95 cases） and positive group （57 cases）. All ASCUS patients were inspected by vaginal speculum and cervical histopathological examination, using SPSS16.0 software to analyze the data statistically. RESULTS In 152 cases of ASCUS, 57 cases were high-risk HPV positive, accounting for 36.8 % ; and the positive rate of cervical histopathological examination was 63.16 % in the high-risk HPV positive group, while 3.15 in high-risk HPV negative group. Comparing the results, the difference had statistical significance （P0. 01）. CONCLUSION The detection o HC2 HPV DNA is the most efficient, easy, economic and non-invasive method for the women patients of ASCUS.