宫颈液基细胞学为ASCUS患者HPV检测的意义

Clinical value of liquid-based cervical cytology in HPV detection for patients with atypical squamous cells of undetermined significance

目的探讨高危型人乳头瘤病毒（high—risk human papilloma virus，HR—HPV）能否作为意义未明的不典型鳞状细胞（atypical squamous cells of undetermined significance，ASCUS）患者处理的分流指标。方法回顾性分析2016年1月1日至2016年12月30日于本院妇科就诊，同时行宫颈液基细胞学（thinprep cytologic test，TCT）、HPV检测，TCT结果为ASCUS的583例患者的临床病理资料，比较高危型HPV阳性患者与高危型HPV阴性患者的宫颈病变情况。结果高危型HPV阳性组病理结果为：宫颈上皮内瘤变（cervical intraepithelial lesions，CIN）Ⅱ级及以上病变检出率为15．7％（47／300），显著高于高危型HPV阴性组的0．7％（2／283）。不同年龄段的ASCUS患者HPV感染率、宫颈高级别病变率差异无统计学意义。结论宫颈上皮内高级别病变的发生与高危型HPV感染密切相关，高危型HPV检测可以作为ASCUS患者分流的主要手段。

Objective To investigate whether high-risk human papilloma virus （HR-HPV） can be used as an indicator for management of patients with TCT results of atypical squamous cells of undetermined significance （ASCUS）. Methods From Jan. 1, 2016 to Dec. 30, 2016, the clinical data of 583 patients with results of ASCUS in our hospital was retrospectively analyzed. The cervical lesions of HR-HPV positive patients and HR-HPV negative patients were compared. Results The detection rate of grade Ⅱ and above cervical intraepithelial neoplasia （CIN） was 15.7% （47/300） in HR-HPV positive group, significantly higher than 0.7% （2/283） in HR-HPV negative group. There were no statistically significant differences in HPV infection rate or high grade cervical lesion rate among different age groups. Conclusion The occurrence of high grade CIN is closely related to HR- HPV infection, and the HR-HPV test can he used as a main indication for administration of patients with ASCUS.