高危型人乳头瘤病毒检测在宫颈不典型鳞状细胞患者临床管理中的作用

Effect of high risk human papillomavirus detection in clinical management of patients with cervical atypical squamous cells

目的:探讨高危型人乳头瘤病毒(HR HPV)检测在临床管理宫颈不典型鳞状细胞中的作用。方法:采用第二代杂交捕获法(HC2)对268例宫颈细胞学检查为诊断意义不明的不典型鳞状细胞(ASCUS)的患者进行HR HPV检测,同时行阴道镜检查及病理活检,分析高危型人乳头瘤病毒感染与宫颈病变关系及临床中对ASCUS患者的管理。结果:268例患者中,病理组织学为炎症121例(45.2%),宫颈上皮内瘤变(CIN)Ⅰ97例(36.19%),CINⅡ27例(10.07%),CINⅢ19例(7.09%),宫颈浸润癌4例(1.49%),其中HR HPV阳性率53.36%(143例),CIN及以上病变在阳性组中检出率82.00%(118例),明显高于阴性组23.86%(29例),与CIN及宫颈癌有明显相关性,HPV阳性组ASCUS病例的CIN检出率明显高于HPV阴性组,差异有统计学意义(P<0.01)。结论:HR HPV检测对分流ASCUS中的高危人群有重要的临床意义,对阳性者做进一步的阴道镜检查与活检是明确诊断的较好路径,阴性者可随访观察。

Objective:To explore the effect of high risk human papillomavirus detection in clinical management of patients with cervical atypical squamous cells.Methods:268 cases with atypical squamous cells(ASCUS) whose diagnosis were unclear with cervical cytology were given HR HPV detection with the second generation of hybrid capture(HC2),at the same time,they were given colposcopy and biopsy.We analyzed the relationship of high-risk HPV infection with cervical lesions and the management of ASCUS patients in clinic.Results:In 268 cases,histopathology was inflammation in 121 cases(45.2%),97 cases(36.19%) were CIN Ⅰ,27 cases(10.07%) were CIN Ⅱ,19 cases(7.09%) were CIN Ⅲ,4 cases(1.49%) were invasive cervical cancer.Among them, the positive rate of HR HPV was 53.36%(143 cases).The positive detection rate of CIN and above lesions in the positive group was 82%(118 cases).It was significantly higher than that in the negative group of 23.86%(29 cases),and had a significant correlation with CIN and cervical cancer.The positive rate of CIN of ASCUS cases in the HPV positive group was significantly higher than that in HPV negative group,and the difference was statistically significant(P<0.01).Conclusion:HR HPV detection has important clinical significance for shunting high-risk groups in ASCUS.It is a better path for clear diagnosis of positive patients with colposcopy and biopsy.Negative people can be observed.