HPV联合阴道镜检查对宫颈不典型鳞状细胞患者分流的意义

Significance of HPV test combined with colposcopy in distribution of patients with cervical atypical squamous cells

目的探讨人乳头状瘤病毒(HPV)联合阴道镜检查对宫颈不典型鳞状细胞(ASCUS)患者分流的意义。方法抽取2015年1月至2019年1月大同市中西医结合医院收治的宫颈细胞学检查结果示ASCUS的患者214例,均行宫颈细胞学、高危型人乳头状瘤病毒(HR-HPV)、阴道镜及活组织病理检查,并分析检查结果。结果214例ASCUS患者活组织病理检查结果示炎症135例,湿疣24例,CINⅠ17例,CINⅡ20例,CINⅢ15例,浸润癌1例,腺癌1例,高度腺上皮异常1例,低度腺上皮异常0例。214例ASCUS患者HR-HPV阳性173例,HR-HPV阴性41例。炎症、湿疣、CINⅠ、CINⅡ、CINⅢ、浸润癌、腺癌、腺上皮异常HR-HPV阳性者检出例数分别为120例、19例、14例、9例、10例、0例、0例、1例,HR-HPV阴性者检出例数分别为15例、4例、3例、11例、5例、1例、1例、0例。组织病理学检查结果中炎症、湿疣、CINⅠ患者中共有高度阴道镜检评分(3分及以上,高度CIN)141例,CINⅡ、CINⅢ中共有27例高度CIN;浸润癌、腺癌、高度腺上皮异常中共有2例高度CIN,两者差异比较有统计学意义(Z=-24.621,P<0.05)。结论HPV联合阴道镜检查能减少ASCUS假阳性判定,有利于临床分流高危型ASCUS患者。

Objective To investigate the value of human papillomavirus (HPV) test combined with colposcopy in the diagnosis of distribution of patients with cervical atypical squamous cells (ASCUS).Methods A total of 214 patients with ASCUS who had cervical cytology examinations from January 2015 to January 2019 in Datong Integrated Hospital of Traditional Chinese and Western Medicine were selected. All patients underwent cervical cytology, high risk human papilloma virus(HR-HPV), colposcope and biopsy pathology examination, and the results were analyzed.Results The results of histopathological examination in 214 patients with ASCUS were as follows: 135 cases of inflammation, 24 cases of condyloma, 17 cases of cervical intraepithelial neoplasia (CIN Ⅰ), 20 cases of CIN Ⅱ, 15 cases of CIN Ⅲ, 1 case of invasive cancer, 1 case of adenocarcinoma, 1 case with high degree of glandular epithelium abnormality and 0 case with low degree of glandular epithelium abnormality. Among the 214 patients with ASCUS, 173 cases were positive and 41 cases were negative by HR-HPV. The number of HR-HPV positive cases in patients with inflammation, genital warts, CINI, CINII, CINIII, invasive carcinoma, adenocarcinoma, and high glandular epithelial abnormalities were 120 cases, 10 cases, 14 cases, 9 cases, 10 cases, 0 case, 0 case, 1 case. The number of HR-HPV negative cases in patients with inflammation, genital warts, CIN I, CIN II, CIN III, invasive carcinoma, adenocarcinoma, and high glandular epithelial abnormalities were 15 cases, 4 cases, 3 cases, 11 cases, 5 cases, 1 case, 1 case, 0 case. Histopathological examination results showed that there were a total of 141 cases of high CIN, 3 points and above in patients with inflammation, genital warts and CINI. There were 27 cases of high CIN in CIN II and CIN III.There were 2 cases of high CIN in invasive carcinoma, adenocarcinoma, high glandular epithelial abnormality, and low grade glandular epithelial abnormalities. The difference between the two was significant (Z=-24.621, P<0.05).Conclusions HPV combined with colposcopy can reduce ASCUS false positive, which is beneficial for clinical of hig-risk ASCUS patients.