妇科体检人群HPV感染分型、液基薄层细胞学检查及阴道微生态检查结果分析

Analysis of HPV infection type,liquid base thinprep cytologic test and vaginal microecological examination results in gynecological examination population

目的掌握妇科体检人群HPV感染状况、细胞学诊断及阴道微生态检查结果,发挥基层医疗门诊哨岗作用,以期为临床诊疗提供基础数据。方法样本来源于自愿接受检查的妇科体检人员,采集体检者子宫颈分泌物、脱落细胞及阴道分泌物,进行人乳头瘤病毒(HPV)分型检测、液基薄层细胞学检查(TCT)及阴道微生态分析。结果HPV分型检测结果显示,体检人群中HPV感染分型检出率较高的前10位依次为HPV58、16、81、52、53、31、51、66、68、39、56型,以高危型感染为主;年龄分组比较显示,≤25岁组、26~35岁组、36~45岁组的HPV高危型感染阳性频次多于HPV低危型感染阳性频次,且差异有统计学意义(P<0.01)。TCT诊断分型有高级别鳞状上皮内病变(HSIL)、低级别鳞状上皮内病变(LSIL)、未明确诊断意义的不典型鳞状细胞(ASC-US)以及未见上皮内病变及恶性细胞等四种,其HPV阳性率差异具有统计学意义(P<0.01);HPV阳性者的HPV分型均以高危型为主;在75例TCT阳性病例中有15例(20%)感染HPV16、18型;HPV阳性者的阴道微生态异常比例较高(80.77%)。结论防治子宫颈癌应尽早接种疫苗、定期筛查、积极治疗三管齐下,子宫颈癌筛查作为二级预防措施应受到临床关注,并重视HPV高危型的筛查工作。

Objective To master the results of HPV infection status,cytologic diagnosis and vaginal microecological examination in gynecological physical examination population,and to play the role of sentinel in primary medical outpatient clinics,in order to provide basic data for clinical diagnosis and treatment.Methods The samples were collected from gynecological examiners who volunteered to be examined.The cervical secretions,exfoliated cells and vaginal secretions were collected for human papillomavirus(HPV)type,liquid base thinprep cytologic test(TCT)and vaginal microecological analysis.Results HPV type test results showed that the top 10 types of HPV in the physical examination population were HPV58,16,81,52,53,31,51,66,68,39,56,mainly high-risk type infection.The comparison of age groups showed that the positive frequency of HPV high-risk infection in≤25 years old group,26~35 years old group and 36~45 years old group was higher than that of HPV low-risk infection,and the difference was statistically significant(P<0.01).TCT diagnostic classification included high-grade squamous intraepithelial lesion(HSIL),low-grade squamous intraepithelial lesion(LSIL),atypical squamous cell of undetermined significance(ASC-US),and no intraepithelial lesion and malignant cell(NILM).The difference in HPV infection rate was statistically significant(P<0.01).The HPV type of HPV positive patients were mainly high-risk types.There were 15 cases(20%)infected with HPV type 16,18 in the 75 TCT positive cases.The proportion of vaginal microecological abnormalities was high among HPV infected persons(80.77%).Conclusion Prevention and treatment of cervical cancer should early vaccinate,regularly screen,and actively treat.Cervical cancer screening as a secondary preventive measure should be clinically concerned,and attention should be paid to the screening of high-risk HPV types.