高危型人乳头瘤病毒检测在宫颈环形电切治疗中的意义  

Significance of detecting high risk human papillomavirus before loop electrosurgical excisional procedure

作　　者：杨爱宏[1] 董彩霞 许飞雪[1] 杨永秀[1] 

机构地区：[1]兰州大学第一医院妇产科,兰州73000 [2]兰州石化总医院放射科,兰州730060

出　　处：《中国卫生检验杂志》2012年第7期1627-1629,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:研究高危型人乳头瘤病毒(HR-HPV)对非典型鳞状细胞(ASC)或低度鳞状上皮内病变(LSIL)患者进行宫颈环形电切(LEEP)治疗的辅助诊断价值。方法:回顾性分析186例ASC或LSIL患者的HR-HPV检测、阴道镜下活检病理和LEEP病理结果,比较HR-HPV阳性和阴性患者中高级别病变(CIN2+)的发生率。结果:ASCUS、ASC-H和SLIL患者中HR-HPV的阳性率分别为67.1%、75.0%和89.3%,活检病理结果为CIN2+的比例分别为13.4%、60.0%和32.1%,而LEEP病理结果为CIN2+的比例分别为19.5%4、5.0%和33.3%。最终病理结果为CIN2+的患者在HR-HPV阳性患者中的比例为37.9%,而在HR-HPV阴性患者中的比例为17.0%,差异具有显著性(χ2=5.873,P=0.015)。结论:细胞学结果为低级别病变的患者中存在较高比例的高级别病变患者,检测HR-HPV有助于及时发现高级别病变患者。Objective：To investigate the significance of detecting high risk human papillomavirus（HR-HPV） in patients with atypical squamous cells（ASC） or low-grade squamous intraepithelial lesion（LSIL） before loop electrosurgical excisional procedure（LEEP） treatment.Methods： A total of 186 patients with ASCUS,ASC-H,or LSIL were retrospectively analyzed.Results of HR-HPV detection,biopsy and LEEP biopsy were reviewed.The occurrence rates of cervical intraepithelial neoplasia 2 or worse（CIN2＋） were compared between HR-HPV positive and negative patients.Results： The positive rates of HR-HPV in patients with ASCUS,ASC-H and LSIL were 67.1%,75% and 89.3%,respectively.The occurrence rates of CIN2＋ were 13.4%,60% and 32.1% by biopsy,respectively,and 19.5%,45.0% and 33.3% by LEEP pathology,respectively.The final pathology results of CIN2＋ were found in 37.9% of the patients with HR-HPV infection,significantly higher than that in HR-HPV negative patients（17.0%,χ2=5.873,P=0.015）.Conclusion： High grade cervical intraepithelial neoplasia was found in many patients with low grade lesions tested by cytological test.Detection of HR-HPV may be useful to find high grade neoplasia early and timely.

关 键 词：宫颈环形电切 人乳头瘤病毒 非典型鳞状细胞 LSIL CIN 

分 类 号：R737.33[医药卫生—肿瘤]