细菌性阴道病加速宫颈上皮内瘤变1例报告

One case report of bacterial vaginosis accelerateing cervical intraepithelial neoplasia

细菌性阴道病（BV）是女性生殖道感染最常见的疾病,本文报道1例反复BV且液基薄层细胞学检查（TCT）3次均为无明确诊断意义的不典型鳞状细胞（ASCUS）的患者的临床资料。该患者从首次TCT示ASCUS到阴道镜活检病理示宫颈上皮内瘤变（CIN）玉、见挖空细胞仅6个半月,从CIN玉到LEEP术后病理示CINⅠ~Ⅱ为21个月,提出BV长期存在,增加了人乳头瘤病毒（HPV）感染的几率,延迟了HPV的消退,加速了CIN的发展进程。当TCT出现ASCUS时,如有BV、宫颈炎时,应积极对症规范治疗,配偶也应积极配合检查治疗,以减缓CIN的发展进程。该患者愈后复查TCT,如果仍为ASCUS,应检测HPV DNA,必要时阴道镜活检,定期进行TCT、HPV检测,以降低宫颈CIN的漏诊率,预防宫颈癌的发生。

Bacterial vaginosis （BV） is the most common disease in female reproductive tract infection.One case of re-current BV after three times thinprep cytology test （TCT） with the diagnosis of atypical squamous cells of undetermined significance （ASCUS） was reported in the paper.Only 6 months from ASCUS occurred by TCT in the first time to cervi-cal intraepithelial neoplasia Ⅰ by colposcopy histopathology took it when koilocytes were developed.21 months were needed from CIN Ⅰ to CIN II after loop electrosurgical excision procedure （LEEP） by histopathology.It was put for-ward that long-term existence of BV increased the risk of human papillomavirus （HPV）,delayed its disappearance,and accelerated development progress of CIN.When ASCUS occurred after TCT,if accompanied with BV and cervicitis,the symptomatic standard treatment was necessary in an active way,and the spouse should also actively cooperate with the examination and treatment at the same time in order to slow the development process of CIN.After being cured,recur-rent examination of TCT was needed.If ASCUS was still in existence,HPV DNA should be tested,and colposcopy histopathology in necessary.Tests of TCT and HPV at regular intervals can reduce the rate of missed diagnosis in cer-vical CIN,and prevent the occurrence of cervical cancer.