HPV检测和液基细胞学检查在宫颈病变筛查中的应用  

Application of HPV detection and cytology test in cervical lesion screening

作　　者：杨怡卓[1] 李亚里[1] 李萍[1] 付玉荣[1] 徐滨[1] 

机构地区：[1]解放军总医院妇产科,北京100853

出　　处：《解放军医学杂志》2007年第12期1288-1290,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的通过与病理组织学检查结果比较,评价高危型人乳头瘤病毒(HR-HPV)检测和液基细胞学检查在宫颈病变筛查中的应用价值。方法对2004年12月～2006年12月在解放军总医院行HR-HPV和液基细胞学检查及电子阴道镜下宫颈活组织病理检查的690例患者的资料进行回顾性分析。结果690例患者中液基细胞学与病理组织学检查的符合率为:低度鳞状上皮内病变(LSIL)22.34%(42/188),高度鳞状上皮内病变(HSIL)58.33%(56/96),宫颈癌100%(16/16)。细胞学结果示良性细胞改变75例;不典型鳞状细胞(ASC)、LSIL、HSIL和宫颈癌者分别为315、188、96、16例,其HR-HPV阳性率分别为53.96%(170/315)、77.12%(134/188)、80.21%(77/96)和100%(16/16)。经阴道镜下多点活检病理组织学诊断为炎症、上皮内瘤变Ⅰ级和(或)湿疣(CINⅠ/HPV)、CINⅡ/CINⅢ、宫颈浸润癌者分别为425、81、157和27例,其HR-HPV阳性率分别为43.29%(184/425)、74.93%(60/81)、91.72%(144/157)和92.5%(25/27)。此外,413例HR-HPV阳性者中,病理学≥CINⅠ/HPV者占55.45%(229/413);277例HR-HPV阴性者中,病理学为炎症者占87.01%(241/277),≥CINⅠ/HPV者占12.99%(36/277),而36例≥CINⅠ/HPV者中CINⅡ/CINⅢ和宫颈浸润癌仅占5.42%(15/277)。315例ASC中,HR-HPV阳性者170例,病理学≥CINⅠ/HPV占41.76%(71/170),其中CINⅡ/CINⅢ和宫颈浸润癌占69.01%(49/71);HR-HPV阴性145例,病理学≥CINⅡ/CINⅢ者仅占4.83%(7/145),炎症占90.34%(131/145)。结论HR-HPV和液基细胞学检查是筛查宫颈病变的有效方法,二者结合有利于宫颈病变的分流管理,提高宫颈癌及癌前病变的检出率。Objective To evaluate the high-risk human papillomavirus（HR-HPV）detection and thinprep cell test（TCT）in the diagnosis of cervical lesion by comparison with pathological findings.Methods The data collected from Dec.2004 to Dec.2006 from 690 patients who had undergone HR-HPV detection,TCT and pathology examination with electronic colposcopy in the Department of Obstetrics and Gynecology,General Hospital of PLA were analyzed retraspactively.Results Among the 690 patients,the coincidence between the findings of TCT and pathology was 22.34%（42/188）for low-grade squamous intraepithelial lesion（LSIL）,58.33%（56/96）for high-grade squamous intraepithelial lesion（HSIL）and 100%（16/16）for cervical cancer.The number of patients with the cytological diagnosis of abnormal squamous cells（ASC）,LSIL,HSIL and cervical cancer was 315,188,96 and 16,respectively.Among them,the positive rate of HR-HPV of ASC,LSIL,HSIL and cervical cancer was 53.96%（170/315）,77.12%（134/188）,80.21%（77/96）and 100%（16/16）,respectively.Pathologic examination through electronic colposcopy revealed the number of patients with the diagnosis of inflammation,CINⅠ/HPV,CINⅡ/CINⅢ and invasive cancer was 425,81,157 and 27,respectively.Among them,the positive rate of HR-HPV in inflammation was 43.29%（184/425）,CINⅠ/HPV 74.93%（60/81）,CINⅡ/CINⅢ 91.72%（144/157）and invasive cancer 92.5%（25/27）.Among the 690 cases,413 were HR-HPV positive,55.45%（229/413）of which showed CINⅠ/HPV or higher.277 cases were HR-HPV negative,and 87.01%（241/277）of which showed inflammation,12.99%（36/277）of which showed CINⅠ/HPV or higher,and 5.42%（15/277）of which showed CINⅡ/CINⅢ and invasive cervical cancer.Among 315 cases with ASC,170 cases were HR-HPV positive,41.76%（71/170）of which showed CINⅠ/HPV or higher,including 69.01%（49/71）CINⅡ/CINⅢ and invasive cervical cancer.145 cases were HR-HPV negative,only 4.83%（7/145）of which was CINⅡ/CINⅢ and invasive cervical cancer,and 90.3

关 键 词：宫颈疾病 细胞学技术 乳头瘤病毒 人 

分 类 号：R737.33[医药卫生—肿瘤]