高危型人乳头瘤病毒在子宫颈疾病筛查中的临床分析

Clinical Application of High-risk Human Papillomavirus in Cervical Screening

目的分析子宫颈疾病筛查中检测高危型人乳头瘤病毒(HRHPV)的临床意义。方法我院2015年4月—2018年6月联合液基细胞学(TCT)与HR-HPV检测者414例,其中384例细胞学正常但HR-HPV检测阳性或细胞学正常、HR-HPV检测阴性但高度怀疑病变患者结合病理结果进行分析。结果 TCT联合HR-HPV检测的414例患者中,TCT正常或炎症、ASC-H和ASC-US、LSIL、HSIL的HR-HPV阳性率分别为22.4%、47.2%、71.8%、88.9%,随着细胞学诊断级别的升高,HR-HPV阳性率显著上升(P<0.05)。结合病理诊断的384例患者中,正常或炎症、CIN1、CIN2、CIN3、SCC、湿疣的HPV-DNA阳性率分别为21.3%、83.3%、86.1%、87.5%、91.7%、72.5%,与正常或炎症比较差异具有统计学意义(P<0.05)。结论随着细胞学形态异型病变级别的升高,HR-HPV阳性率逐渐上升,其与宫颈病变的演进密切相关,用于子宫颈癌筛查对疾病诊断和预后评估有一定的临床意义。

Objective To analyze the clinical significance of detecting high-risk human papillomavirus in cervical disease screening. Methods In our hospital, 414 patients from April 2015 to June 2018 were combined with liquid-based cytology （TCT） and HR-HPV, of which 384 were normal cytology but positive for HR-HPV or normal for cytology and negative for HR-HPV. However, highly suspected patients with pathology were analyzed for pathological fndings. Results The HR-HPV positive rates of TCT normal or infammation, ASC-H and ASC-US, LSIL, and HSIL were 22.4%, 47.2%, 71.8%, and 88.9%, respectively, in 414 patients with TCT and HR-HPV. The cytological diagnosis level increased, and the HR-HPV positive rate increased signifcantly （P 〈 0.05）. Among the 384 patients with pathological diagnosis, the positive rates of HPV-DNA in normal or inflammation, CIN1, CIN2, CIN3, SCC, and genital warts were 21.3%, 83.3%, 86.1%, 87.5%, 91.7%, and 72.5%, respectively. Or infammation was statistically diferent （P 〈 0.05）. Conclusion With the increase of cytological morphological grades, the positive rate of HR-HPV gradually increases, which is closely related to the evolution of cervical lesions. The screening for cervical cancer has certain clinical signifcance for disease diagnosis and prognosis evaluation.