宫颈人乳头病毒6与11型感染阴道镜检查的必要性探讨

Discussion on the necessity of colposcopy in cervical human papilloma virus 6 and 11 infection

目的探讨宫颈人乳头病毒(HPV)6、11型阳性,宫颈液基薄层细胞学(TCT)正常且无自觉症状女性进行阴道镜检查的必要性。方法选取2016年1月至2019年9月本院收治的172例HPV6、11型阳性,TCT检查正常且无自觉症状女性作为研究对象,均行妇科检查、阴道镜检查,记录并分析检查结果。结果妇科检查宫颈光滑116例,行阴道镜检查结果均为宫颈HPV6、11型潜伏感染;妇科检查宫颈单纯型糜烂样改变52例,行阴道镜检查、组织病理检查发现宫颈HPV6、11型宫颈潜伏感染9例(17.3%),亚临床感染24例(46.1%),临床感染(宫颈尖锐湿疣)19例(36.5%),妇科检查宫颈颗粒型糜烂样改变4例,行阴道镜检查、组织病理检查发现HPV6、11型临床感染(宫颈尖锐湿疣)4例(100.0%)。宫颈单纯型糜烂样改变病理结果异常明显高于宫颈光滑者,差异有统计学意义(P<0.05),宫颈单纯型糜烂样改变的宫颈HPV临床感染及亚临床感染率与宫颈颗粒型糜烂样改变比较差异无统计学意义。结论HPV6、11型阳性,TCT正常,无自觉症状妇女,妇科检查宫颈光滑者可不转诊阴道镜;妇科检查宫颈有赘生物或有糜烂样改变者应转诊阴道镜,以发现肉眼难以识别的宫颈HPV6、11型临床感染(宫颈尖锐湿疣)及宫颈HPV6、11型亚临床感染,及时治疗宫颈HPV6、11型临床感染(宫颈尖锐湿疣)及亚临床感染,指导潜伏感染者使用避孕套,以防止性疾病传播。

Objective To investigate the necessity of colposcopy in women with cervical human papilloma virus(HPV)6 and 11 positive,normal thinprep cytologic test(TCT)and asymptomatic women.Methods From January 2016 to September 2019,172 women with positive HPV6 and 11 types,normal TCT examination and asymptomatic patients who were admitted to our hospital were selected as the research subjects.All of them underwent gynecological examination and colposcopy examination,and the examination results were recorded and analyzed.Results 116 cases of gynecological examination with smooth cervix underwent colposcopy and the results were all cervical HPV6 and 11 latent infection;52 cases of cervical simple erosion-like change were found in gynecological examination;colposcopy and histopathological examination revealed cervical HPV6 and 11 latent cervical infection 9 cases(17.3%),24 cases(46.1%)of subclinical infection,19 cases(36.5%)of clinical infection(cervical condyloma acuminatum),4 cases of cervical granular erosion-like changes in gynecological examination,colposcopy and histopathological showed that 4 cases(100.0%)of HPV6,type 11 clinical infection(cervical condyloma acuminatum).The pathological results of the cervical simple erosive changes were significantly higher than those of the smooth cervix,and the difference was significantly significant(P<0.05).There was no significant difference in the cervical HPV clinical infection and subclinical infection rate and the cervical granular erosive changes.Conclusion HPV6 and 11 positive,normal TCT,asymptomatic women,those with smooth cervix in gynecological examination may not be referred to colposcopy,those with cervical vegetations or erosion-like changes in gynecological examination should be referred to colposcopy,in order to find out the difficult to identify with naked eye.Cervical HPV6,11 clinical infection(cervical condyloma acuminatum)and cervical HPV6,11 subclinical infection,timely treatment of cervical HPV6,11 clinical infection(cervical condyloma)and subclinical infection and instruct latent infection to use condoms,and Prevent the spread of sexually transmitted diseases.