高危型人乳头瘤病毒检测联合阴道镜下宫颈活检对CIN和早期浸润癌的诊断价值

Clinical value of high-risk human papillomavirus detection combined with colposcopy-guided cervical biopsy in CIN and early invasive carcinoma

目的研究高危型人乳头瘤病毒(HPV)检测联合阴道镜下宫颈活检对癌前病变(CIN)和早期浸润癌的临床诊断价值。方法选取2013年5月至2014年5月在我院门诊行高危型HPV检测者859例,HPV阳性者或者部分阴性者伴有可疑病变者行阴道镜下活检,并且给予病理学检查。结果所有受检者中高危型HPV阳性者211例,阳性率为24.6%,其中<35岁者阳性率为24.4%(107/438),≥35岁者阳性率为24.7%(104/421),两者比较差异无统计学意义(P>0.05);行阴道镜活检387例,其中病理结果为CINⅠ者52例,CINⅡ者34例,CINⅢ者5例,早期浸润癌者2例。CINⅠ、CINⅡ、CINⅢ以及早期浸润癌高危型HPV的感染率分别为73.1%(38/52)、88.2%(30/34)、100.0%(5/5)和100.0%(2/2),各组间比较差异具有统计学意义(P<0.05)。结论随着宫颈癌病变级别的增加,高危型HPV的检出阳性率也随之升高,联合阴道镜下活检能明确病理类型。

Objective To analyze the clinical value of high-risk human papillomavirus（HPV） detection combined with colposcopy-guided cervical biopsy in cervical intraepithelial neoplasia（CIN） and early invasive carcinoma.Methods A total of 859 patients,who was tested for high-risk HPV in our hospital from May 2013 to May2014,were selected as the research subjects.HPV-positive or partially negative patients with suspicious lesions were examined with colposcopy-guided cervical biopsy for pathological examination.Results Two hundred eleven cases of all subjects were high-risk HPV-positive with the positive rate of 24.6%.The positive rate was 24.4%（107/438） in those younger than 35 years old and 24.7%（104/421） in those greater than or equal to 35 years of age,and the difference was not statistically significant（P〉0.05）.Among of 387 cases examined with colposcopy-guided cervical biopsy,there were52 cases of CIN Ⅰ,34 cases of CIN Ⅱ,5 cases of CIN Ⅲ,2 cases of early invasive carcinoma in the pathological results.The high-risk HPV infection rate of CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and early invasive carcinoma were 73.1%（38/52）,88.2%（30/34）,100.0%（5/5） and 100.0%（2/2）,respectively,and there was no significant difference among the groups（P〈0.05）.Conclusion The high-risk HPV positive detection rate rises with the increase of grade of cervical lesions,which combined with cervical biopsy by colposcopy can clearly identify the pathological type.