【摘要】 目的:探讨HR-HPV检测和阴道镜检查在不典型鳞状细胞(ASCUS)进一步处理措施中的分流作用。方法:对宫颈液基细胞学诊断为ASCUS的385例患者,分别进行HPV检测、阴道镜评估及镜下活组织检查。结果:385例ASCUS患者,组织学诊断为CIN 125例,发生率32.47%(125/385),其中高级别CIN(≥CINⅡ)及宫颈癌35例,占9.09%(35/385)。HR-HPV阳性215例,阳性率55.84%(215/385),HR-HPV阳性组CIN检出率为46.98%(101/215),HR-HPV阴性组CIN检出率为14.21%(24/170),两组比较差异有统计学意义,χ2=46.75,P<0.01。阴道镜拟诊≥CINⅡ28例,符合24例,符合率85.71%。HR-HPV检测对发现ASCUS中≥CINⅡ病变的敏感性和阴性预测值分别为91.43%(32/35)和98.24%(167/170),阴道镜检查则分别为68.57%(24/35)和96.92%(346/357)。结论:ASCUS中存在高比例的CIN,包括高级别病变和浸润癌。HR-HPV检测是一项敏感的分流手段,可有效浓缩ASCUS中潜在的CIN患者。更多还原

【Abstract】 OBJECTIVE: To investigate the applicability of HR-HPV testing and colposcopic inspection on triaging atypical squamous cells of undetermined significance(ASCUS).METHODS:A total of 385 patients with ASCUS liquid-based cytology were undergone with HPV testing,colposcopic inspections and cervical biopsies.RESULTS: Of the 385 ASCUS cases,125 cases were histologically diagnosed as CIN,with a prevalence of 32.47%(125/385).Among which,35 cases,9.09%(35/385),were high-grade CIN(≥CINⅡ)or cervical cancer.For HPV testing,215 cases were HPV-positive,with a rate of 55.84%(215/385).The proportion of CIN for the group of HPV-positive was 46.98%(101/215),while the proportion for HPV-negative was 14.21%(24/170).The discrepancy was statistically significant(χ2=46.75,P<0.01).On colposcopic inspection,28 cases were diagnosed with ≥CINⅡ.Among which,24 cases were ultimately confirmed,with a concordance of 85.71%.The sensitivity and negative predictive value of HR-HPV testing and colposcopy on triaging ASCUS with ≥CINⅡ lesions were 91.43%(32/35),98.24%(167/170) and 68.57%(24/35),96.92%(346/357) respectively.CONCLUSIONS: Histological diagnosis reveals a high proportion of CIN in ASCUS,including high-grade lesions and cervical cancer.HR-HPV testing is a sensitive tool to identify CIN among ASCUS patients.更多还原