宫颈细胞学筛查阴性、高危型人乳头瘤病毒检查阳性患者220例病理检查分析

Biopsy pathological analysis of 220 cases of cervical cytology negative and high-risk HPV positive

目的分析宫颈细胞学筛查阴性、高危型人乳头瘤病毒(HPV)检查阳性患者宫颈活检病理检查的意义。方法回顾性分析绍兴市人民医院2014年1月至2019年5月收治的细胞学筛查阴性、HPV16/18阳性或间隔1年其他12种高危型HPV(12HR-HPV)持续阳性1年以上的患者220例的宫颈活检病理资料。结果220例中,腺癌3例,宫颈上皮内瘤变Ⅲ级(CINⅢ)18例,CINⅡ18例,CINⅠ69例,湿疣样变47例,慢性炎症65例。在36例高级别鳞状上皮内病变中,有35例是HPV16/18阳性,约占15.91%(35/220),只有1例为其他12种高危型HPV持续阳性1年以上,约0.45%(1/220)。结论宫颈细胞学筛查有可能出现假阴性,对于细胞学阴性、高危型HPV阳性尤其是HPV16/18阳性,立即进行阴道镜宫颈活检,可以减少宫颈高级别鳞状上皮内病变甚至癌变的漏诊。

Objective To explore the clinical significance of biopsy pathological examination of cervical cytology negative,high-risk human papillomavirus(HPV)positive.Methods The pathological data of cervical biopsy in 220 patients with cytological negative,HPV16/18 positive or interval of 1 year other 12 high-risk HPV(12HR-HPV)lasting positive for more than 1 year from January 2014 to May 2019 were retrospectively analyzed.Results Of 220 patients,there were 3 cases with adenocarcinoma,18 cases with CINⅢ,18 cases with CINⅡ,69 cases with CINⅠ,47 cases with condyloma-like lesions,65 cases of chronic inflammation.Among 36 cases of high-grade squamous intraepithelial lesions,there were 35 cases with HPV16/18 positive,accounting for about 15.91%(35/220),and only 1 case of other 12 high-risk HPV was continuously positive for more than one year,accounting for 0.45%(1/220).Conclusion Cervical cytological screening may appear false negative,high-risk HPV typing examination may be more able to detect cervical intraepithelial lesions,for cytological negative,high-risk HPV positive,especially HPV16/18 positive,immediate referral colposcopy can reduce the missed diagnosis of cervical high-grade squamous intraepithelial lesions and even cancerous.