高危型人乳头状瘤病毒检测在不除外高度鳞状上皮内病变的不典型鳞状上皮细胞中的意义  

Significance of hlgh-risk human papiilomavirus DNA in atypical squumous cells, cannot exclude high-grade squamous intraepithelial lesion

作　　者：梅平[1] 刘艳辉[1] 李旻[1] 骆新兰[1] 庄恒国[1] 罗东兰[1] 林华欢[1] 曾仁海[1] 王小冰[1] 邝丽娟[1] 

机构地区：[1]广东省人民医院广东省医学科学院病理科,广州510080

出　　处：《中华病理学杂志》2009年第5期337-339,共3页Chinese Journal of Pathology

基　　金：基金项目：广东省自然科学基金（8151008004000022）

摘　　要：目的探讨高危型人乳头状瘤病毒（HR-HPV）的检测在宫颈细胞学不除外高度鳞状上皮内病变的不典型鳞状上皮细胞（ASC—H）中的意义。方法对45例诊断为ASC—H的患者用杂交捕获二代（HC—Ⅱ）方法检测HR—HPV DNA含量，并进行阴道镜检查及活检，分析其结果之间的关系。结果45例ASC—H的活检结果为宫颈鳞状上皮内病变（SIL）33例（73．3％）；45例ASC—H中36例HR-HPV阳性，其中高度鳞状上皮内病变（HSIL）及以上病变者19例（52．8％）；9例HR—HPV阴性病例中，没有HSIL及以上病变；HR-HPV对ASC—H患者HSIL的敏感性及阴性预测值均为100％。结论ASC-H高度提示宫颈病变的存在；HR—HPV可以作为ASC-H患者是否需要立即阴道镜检查的一个预测指标，HR—HPV阳性者应立即阴道镜检查及活检，HR—HPV阴性是HSIL阴性的一个预测指标。Objective To explore significance of high-risk human papillomavirus （HR-HPV） testing in atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion （ASC-H）. Methods Presence of HR-HPV DNA was examined in 45 patients with ASC-H using hybrid capture Ⅱ （HC-Ⅱ） test. Colposcopic examination and biopsy were taken all results were evaluated. Results Overall, 33 of 45 （73.3 % ） ASC-H cases were biopsy proven cervical intraepithelial lesion （CIN）. 36 of 45 ASC-H cases were HPV-DNA positive, including 19 cases of HSIL and over lesion; whereas no HSIL or over was found in 9 HR-HPV negative cases. Sensitivity and negativity predictive value of HR-HPV in ASC-H with HSIL and over lesion were both 100%. Conclusions ASC-H strongly predicts the presence of HSIL, HR-HPV may serve as a predict select whether a patient with ASC-H should take colposcopic examination immediately, patients with positive HR-HPV should undergo immediate colposcopic examination, while negative HR-HPV is an excellent predictor of the absence of HSIL.

关 键 词：宫颈上皮内瘤样病变 乳头状瘤病毒感染 细胞学技术 

分 类 号：R686[医药卫生—骨科学]