LPT利普液基细胞病理学检查结合HPV分型检测对宫颈疾病患者病变程度的评估及HPV分型检测与ASCUS患者病理结果的关系

Evaluation of pathological changes in patients with cervical diseases by LPT Lipp liquid based cytopathological examination combined with HPV typing detection and the relationship between HPV typing detection and pathological results of ASCUS patients

目的研究超薄液基细胞制片技术(LPT)利普液基细胞病理学检查结合人乳头状瘤病毒(HPV)分型检测对宫颈疾病患者病变程度的评估与无明确意义的非典型鳞状上皮细胞(ASCUS)患者病理结果的关系。方法采用前瞻性研究方法,以2016年1月至2021年9月淮北市妇幼保健院门诊和住院的妇女宫颈疾病患者117例作为研究对象,HPV阴性患者33例,HPV阳性患者84例。HPV阳性患者中,低危型HPV感染患者22例,疑似高危患者16例,高危型HPV感染患者46例。使用取样刷于患者的宫颈口部位进行逆时针刷取病理采样,比较LPT利普液基细胞病理学检出结果、不同HPV感染情况LPT结果以及不同宫颈CINⅠ、CINⅡ、CINⅢ的HPV感染情况之间的差异。结果依据LPT利普液基细胞病理检测发现CINⅠ组45例,CINⅡ组40例,CINⅢ组32例,不同宫颈CINⅠ、CINⅡ、CINⅢ的LSIL、HSIL以及SCC之间的表达差异有统计学意义(P<0.05),同时ASCUS的检出随着上皮内瘤变的程度的增加而减少。不同HPV感染情况患者的LSIL、HSIL以及SCC之间差异有统计学意义(P<0.05),ASCUS的检出在HPV阴性组中最多,在高危HPV组中最少,呈现出从阴性组到高危组中逐渐减少的趋势。不同宫颈CINⅠ、CINⅡ、CINⅢ的HPV感染情况之间差异有统计学意义(P<0.05),其中ASCUS的检出在HPV阴性组中最多,在高危HPV组中最少,呈现出从阴性组到高危组中逐渐减少的趋势。LPT利普液基细胞病理学检查结合HPV分型检测对ASCUS评估的特异度显著高于单独使用HPV分型检测及LPT检测(59.15%vs.54.55%、59.15%vs.50.79%)。通过相关性分析,患者的ASCUS、LSIL、HSIL以及SCC与HPV分型检测结果呈正相关(r=0.441、0.521、0.365、0.584,P<0.05)。结论LPT利普液基细胞病理学检查结合HPV分型检测对宫颈疾病患者病变程度的评估具有积极的意义,HPV分型检测与ASCUS患者病理结果呈现显著的相关性。

Objective To investigate the relationship between liquid-based cell preparation technology(LPT)and human papilloma virus(HPV)typing in the assessment of the extent of lesions in patients with cervical disease and the pathological findings of atypical squamouscells of undP.The relationship between pathological findings in patients with cervical disease and atypical squamouscells of undP.termined significance(ASCUS).Methods A prospective study method was used to study 117 women with cervical disease from January 2016 to September 2021 in outpatients and inpatients at the Huaibei Maternal and Child Health Hospital,with 33 HPV-negative patients,84 HPV-positive patients,and among the HPV-positive patients,22 patients with low-risk HPV infection,16 patients with suspected high-risk,and 46 patients with high-risk HPV infection.Pathological samples were taken by counterclockwise scraping at the cervical os of the patients to compare the differences between the LPT Lipid-based cytopathological findings,the LPT results of different HPV infections and the HPV infections of different cervical CINⅠ,CINⅡand CINⅢ.Results According to LPT Lipp liquid-based cytopathological test,it was found that there were 45 cases in CINⅠgroup,40 cases in CINⅡgroup,and 32 cases in CINⅢgroup.There were significant differences in the expression of LSIL,HSIL and SCC among different cervical CINⅠ,CINⅡand CINⅢ(P<0.05),while the detection of ASCUS decreased with increasing degree of intraepithelial neoplasia(P<0.05).There were significant differences in LSIL,HSIL and SCC among patients with different HPV infection status(P<0.05),with ASCUS detection being highest in the HPV-negative group and lowest in the high-risk HPV group,showing a gradual decrease from the negative to the high-risk group.The difference between HPV infection in CINⅠ,CINⅡand CINⅢwas statistically significant(P<0.05),with ASCUS being detected most in the HPV-negative group and least in the high-risk HPV group,showing a gradual decrease from the negative to the high-risk group.LPT Lipid-based cytopathology examination combined with HPV typing test was significantly more specific for ASCUS assessment than HPV typing test and LPT test alone(59.15%vs.54.55%,59.15%vs.50.79%).By correlation analysis,patients'ASCUS,LSIL,HSIL and SCC showed a positive correlation with HPV typing test results(r=0.441,0.521,0.365,0.584,P<0.05).Conclusion LPT Lipp liquid based cytopathological examination combined with HPV typing has a positive significance in the evaluation of the degree of cervical lesions in patients with cervical diseases.HPV typing detection is significantly correlated with the pathological results of ASCUS patients.