北京地区宫颈细胞学ASC-US患者的病理结果及其影响因素分析  

Prevalence of cervical intraepithelial neoplasia in patients with atypical squamous cells of undetermined significance from cervical pap smears in Beijing

作　　者：王建东[1] 武明辉[2] 张淞文[2] 张为远[3] 

机构地区：[1]首都医科大学附属北京妇产医院妇瘤科,北京100026 [2]首都医科大学附属北京妇产医院保健部,北京100026 [3]首都医科大学附属北京妇产医院妇产科,北京100026

出　　处：《中华肿瘤防治杂志》2010年第4期249-252,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：北京市科委重大项目(D0906008040491)

摘　　要：目的:探讨北京地区宫颈细胞学筛查结果为未明确诊断意义的非典型鳞状上皮细胞(ASC-US)患者进一步检查后的病理结果及其影响因素。方法:2007-03-18-2008-09-26对北京12个区县25～54岁6339例已婚妇女进行了抽样调查,对宫颈细胞学检查结果为ASC-US的409例患者进行了进一步检查和分析。结果:6339例患者宫颈细胞学异常者607例(9.6%),其中ASC-US共409例(6.5%),占宫颈细胞学异常的67.4%。ASC-US/SIL为3.12。409例ASC-US阴道镜下组织活检结果显示炎症者172例(42.1%),宫颈上皮内瘤变(cervicalintraepithelialneoplasia,CIN)Ⅰ级者208例(50.9%),CINⅡ25例(6.1%),CINⅢ3例(0.7%),宫颈癌1例(0.2%)。404例患者(98.8%)接受人乳头瘤病毒(humanpapillomavirus,HPV)检测,显示HPV感染率为30.7%(124/404)。ASC-US患者是否感染HPV与CINⅠ的患病率差异无统计学意义,χ2=1.588,P=0.208;而HPV感染者CINⅡ以上的发生率明显高于未感染HPV者,χ2=26.685,P=0.000;ASC-US的病理结果与HPV感染的负荷量差异无统计学意义,χ2=7.754,P=0.458。结论:北京地区宫颈细胞学ASC-US患者中宫颈上皮内瘤变的患病率较高,应高度重视ASC-US人群,尤其是感染高危型HPV的ASC-US患者。OBJECTIVE：To determine the prevalence and factors associated with cervical intraepithelial neoplasia in patients with atypical squamous cells of undetermined significance from cervical pap smears in Beijing.METHODS：From 2007-0318 to 2008-09-20,6339 married women aged from 25 to 54 years who lived in Beijing more than half one year were detected by cervical smears and high risk HPV tests through a multicenter study.From these smears,409 ASC-US were identified.Follow-up histology findings were analyzed.RESULTS：There were 607（9.6%）abnormal smear results in 6 339 women.Of these,409（67.4%）cases were ASC-US.ASC-US/SIL was 3.12.Biopsy results were obtained for 409 ASC-US,172（42.1%）cases were chronic cervical inflammation,208（50.9%）and 28（6.8%）were confirmed to have cervical intraepithelial neoplasia（CIN）Ⅰ and CIN Ⅱ-CIN Ⅲ,respectively.one（0.2%）cases was confirmed to be invasive cancer.Human papilloma virus tests were obtained for 404（98.8%）of the 409 women with ASC-US,and 124（30.7%）were positive.There was no significant relationship between CINⅠpathology results of ASC-US and HPV infections（χ2=1.588,P=0.208）.More CIN Ⅱ was identified in HPV positive ASC-US than that in HPV negative ASC-US（χ2=26.685,P=0.000）.There was no significant relationship between pathology results of ASC-US and HPV loads（χ2=7.754,P=0.458）.CONCLUSION：ASC-US smears indicate an increased risk of CIN or carcinoma,expecially in women with HPV positive in Beijing area.

关 键 词：宫颈上皮内瘤样病变 乳头状瘤病毒科 活组织检查 细胞学诊断 阴道镜检查 北京 

分 类 号：R737.33[医药卫生—肿瘤]