Schiller试验及HPV检查宫颈上皮内瘤变的临床价值

Clinical Value of Schiller Test and HPV Examination for Cervical Intraepithelial Neoplasia

目的探讨与分析Schiller试验及人乳头状瘤病毒(human papilloma virus,HPV)检查宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的临床价值。方法选取2021年6月—2022年12月在新疆生产建设兵团第十三师红星医院诊治的92例宫颈上皮内瘤变患者作为研究对象,所有患者都给予Schiller试验检查与高危HPV检查,同时也给予病理检查,判断检查的相关性。结果在92例宫颈上皮内瘤变患者中,病理判断为轻度宫颈上皮内瘤变(CIN1级)54例,中度宫颈上皮内瘤变(CIN2级)24例,重度宫颈上皮内瘤变(CIN3级)6例,宫颈癌8例。Schiller试验总阳性率为45.65%(42/92),CIN1级、CIN2级、CIN3级、宫颈癌患者的Schiller试验阳性率分别为24.07%、66.67%、83.33%、100.00%,对比差异有统计学意义(P<0.05)。HPV-16、HPV-18总阳性率为58.70%(54/92)、60.87%(56/92),CIN1级、CIN2级、CIN3级、宫颈癌患者的HPV-16、HPV-18总阳性率分别为24.07%、66.67%、83.33%、100.00%,对比差异有统计学意义(P<0.05)。Schiller试验阳性患者的HPV-16、HPV-18阳性率分别为90.48%、95.23%,都显著高于Schiller试验阴性患者的32.00%、32.00%,差异有统计学意义(P<0.05)。Spearman相关分析显示,CIN患者的Schiller试验阳性与HPV-16阳性、HPV-18阳性等存在相关性(P<0.05)。结论Schiller试验在CIN的诊断阳性率有待提高,多伴随HPV-16、HPV-18阳性,CIN的Schiller试验与HPV检查结果存在相关性,在临床上具有很好的应用价值。

Objective To explore and analyze the clinical values of Schiller test and human papilloma virus(HPV)in detecting cervical intraepithelial neoplasia.Method From June 2021 to December 2022,92 cases of patients with cervical intraepithelial neoplasia who were diagnosed and treated at Xinjiang Production and Construction Corps 13th Division of Hongxing Hospital were selected as the research subjects.All patients were underwent Schiller test and high-risk HPV examination,as well as pathological examination were detected.And the correlation of the examination were determined.Result The pathological diagnosis showed CIN1 grade in 56 cases,CIN2 grade in 24 cases,CIN3 grade in 6 cases,and cervical cancer in 6 cases in the 92 cases.The total positive rates of Schiller test were 45.65%(42/92),and the positive rates of Schiller test for CIN1,CIN2,CIN3,and cervical cancer patients were 24.07%,66.67%,83.33%,and 100.00%,respectively,and diff erences among them were statistically signifi cant(P<0.05).The total positive rates of HPV-16 and HPV-18 were 58.70%(54/92)and 60.87%(56/92),respectively.The total positive rates of HPV-16 and HPV-18 in CIN1,CIN2,CIN3,and cervical cancer patients were 24.07%,66.67%,83.33%,and 100.00%,respectively,and diff erences among them were statistically signifi cant(P<0.05).The positive rates of HPV-16 and HPV-18 in Schiller test positive patients were 90.48%and 95.23%,respectively,which were signifi cantly higher than the 32.00%and 32.00%of Schiller test negative patients(P<0.05).Spearman correlation analysis showed there were correlation between Schiller test positivity,HPV-16 positivity,and HPV-18 positivity in patients with cervical intraepithelial neoplasia(P<0.05).Conclusion The positive diagnostic rate of Schiller test in cervical intraepithelial neoplasia needs to be improved,often accompanied by HPV-16 and HPV-18 positivity.Schiller test for cervical intraepithelial neoplasia is correlated with HPV test results,and has good clinical application value.