阴道上皮内瘤变与TCT、高危型HPV感染及宫颈病变的关系研究

Relationship between vaginal intraepithelial neoplasia and TCT,high-risk HPV infection and cervical lesions

目的探讨阴道上皮内瘤变(VAIN)与液基薄层细胞学检查(TCT)、高危型人乳头瘤病毒(HR-HPV)感染及宫颈病变的关系。方法选取广东省妇幼保健院2016年5月至2018年9月宫颈完整因细胞学筛查异常行阴道镜和组织学检查,诊断为VAIN的患者108例,研究其资料,分析VAIN与TCT、HR-HPV感染及宫颈病变的关系。结果108例VAIN患者中,年龄<42岁者47例(43.52%),≥42岁者61例(56.48%);<42岁者低度鳞状上皮内病变(LSIL)和高度鳞状上皮内病变(HSIL)发病率低于≥42岁者,两组比较差异有统计学意义(P<0.05)。HR-HPV感染呈阳性者95例(87.96%),呈阴性者13例(12.04%),HR-HPV感染在LSIL和HSIL呈阳性率方面比较差异未见统计学意义(P>0.05)。TCT诊断级别的不断提升,VAIN级别也逐渐提高,差异有统计学意义(P<0.05)。78.70%(85/108)的VAIN患者出现宫颈上皮病变合并VAIN的症状,且随着宫颈病变级别的升高,VAIN的级别也逐渐升高(P<0.05)。结论VAIN与年龄、TCT级别、HR-HPV感染及宫颈病变级别均有一定关系。

Objective To investigate the relationship between vaginal intraepithelial neoplasia (VAIN) and thin-cytologic test (TCT), high-risk human papillomavirus (HR-HPV) infection and cervical lesions.Methods A total of 108 patients with VAIN diagnosed by colposcopy and histological examination due to abnormal cytological screening from May 2016 to September 2018 in Guangdong Maternal and Child Health Hospital were selected .The relationship between VAIN and TCT , HR-HPV infection and cervical lesions was analyzed by patients' data.Results Of the 108 patients, 47 cases (43.52%) were younger than 42 years old, and 61 cases (43.52%) were older than 42 years old.The morbidities of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) in patients under 42 years old were significantly lower than those in patients over 42 years old ( P<0.05) .Of the 108 patients with VAIN , HR-HPV infection was positive in 95 cases ( 87.96%) and negative in 13 cases (12.04%) .There was no significant difference in the positive rate of HR-HPV infection between LSIL and HSIL (P>0.05).The diagnostic level of TCT had been continuously improved , and the VAIN level had also been gradually improved simutaneously , and the difference was significant (P<0.05).78.70%(85/108) of VAIN patients had the symptoms of cervical epithelial lesion with VAIN .With the increase of the grade of cervical lesions , the VAIN level was gradually increased ( P<0.05 ) .Conclusions VAIN is associated with age , TCT grade , high risk HPV infection and cervical lesions .