【摘要】 目的探讨宫颈病变与相关病原微生物感染之间的关系。方法液基细胞学筛查356例病例,细胞学诊断采用TBS分级系统,液基标本做薄片细胞学诊断和人乳头瘤病毒(HPV)、疱疹病毒(HSV-Ⅱ)DNA检测、沙眼衣原体(Ct)、解脲支原体(Uu)检测。阳性诊断包括意义不明确的非典型鳞状细胞(ASCUS)以上病变,诊断阳性病变者与阴道镜下多点组织活检结果相比较。结果细胞学检出鳞状细胞癌(SCC)2例,鳞状上皮内高度病变(HSIL)7例,鳞状上皮内低度病变(LSIL)35例,与阴道镜活检阳性符合率分别为LSIL87.50%(35/40)、HSIL70%(7/10)、SCC100%(2/2)。PCR荧光法检出HPV、HSV-Ⅱ及Ct、Uu感染率分别为8.42%(30/356)、2.53%(9/356)、7.87%(28/356)、4.49%(16/356),30例HPV感染者细胞学诊断≥ASCUS,占病理活检阳性率的31.25%(25/80)。结论采用Thinprep液基细胞学联合病原微生物检测,细胞学阳性或临床可疑患者应配合阴道镜检查及镜下活检病理诊断,可提高子宫颈癌前病变及病原微生物感染对宫颈病变的影响的诊断准确率,减少误诊、漏诊,指导临床合理治疗。更多还原

【Abstract】 Objective To investigate the relationship between cervical infection and the development of cervical lesion. Method Exfoliative cervical samples from 356 cases were analyzed by liquid based thinprep cytological and tranditional microscopic examination methods. In the microbiological analysis,cervical samples were screened for human papilloma virus (HPV), HSV-ⅡDNA, Chlamydia trachomatis (Ct) and Ureaplasma urealyticum (Uu). Positive results, including included ASCUS (atypical squamous cells of undetermined significance),were compared with colposcopic biopsy. Result Cytological analysis revealed 2 cases of squamous cell carcinoma (SCC), 7 cases of high grade squamous intra-epithelial lesions (HSIL), and 35 cases of low grade squamous intraepithelial lesions (LSIL). The consistent rate with colposcopic biopsy was 100% (2/2) for SCC,70% (7/10) for HSIL, and 87.50% (35/40) for LSIL, respectively. Fluorescence-PCR revealed that the infection rate for HPV, HSV-Ⅱ, Ct, and Uu was 8.42% (30/356), 2.53% (9/356), 7.87% (28/356) and 4.49%(16/356), respectively. 30 cases of HPV infection showed the cytological characteristics ≥ASCUS, accounting for 31.25% (25/80) of the positive cervical lesion rate. Conclusion Combination of liquid-based thinprep cytological examination, detection of pathogenic microorganisms and colposcopic examination could greatly improve the accuracy of diagnosis of pathohistological change of cervical lesion. The rate of misdiagnosis will also be reduced.更多还原