人乳头瘤病毒检测在宫颈高级别鳞状上皮内病变锥切术后随诊的临床意义  

Clinical Significance of Human Papillomavirus Detection in the Follow up after Conization of Cervical High-grade Squamous Intraepithelial Lesions

作　　者：肖明[1] 罗光霞[1] 王优快[1] 舒爱娥[1] 

机构地区：[1]怀化市第一人民医院妇产科,湖南怀化418000

出　　处：《医学临床研究》2013年第5期877-879,共3页Journal of Clinical Research

摘　　要：【目的】探讨高危型人乳头瘤病毒（HPV）基因与宫颂液基薄层细胞学（TCT）检测在宫颈高级别鳞状上皮内病变（HSIL）锥切术后随诊中的临床意义。【方法】收集本院因宫颈HSIL住院行宫颈冷刀锥切手术治疗，保留子宫者、术后能定期随诊并有完整资料者共80例，分析术后3、4、5、6、12、18、24个月残留率并比较。【结果180例患者术后半年内高危型HPV-DNA阳性18例患者，在阴道镜下行宫颈活检提示有宫颈上皮内瘤变（CIN）6例，符合率33．3％（6／18），TCT提示ASC-US以上病变者10例，阴道镜下行宫颈活检提示有宫颈鳞状上皮内瘤病变6例，符合率60．0％（6／10），两者符合率比较差异有统计学意义（P〈0．05）；半年后高危型HPV-DNA阳性16例，在阴道镜下行宫颈活检提示有宫颈鳞状上皮内瘤病变6例，符合率37．5％（6／16），TCT提示ASC-US以上病变者6例，在阴道镜下行宫颈活检提示有宫颈鳞状上皮内瘤病变1例，符合率16．7％（1／6），两者符合率比较差异有统计学意义（P〈0．05）。【结论】宫颈HSIL锥切术后半年内采取TCT筛查宫颈早期病变，术后半年后提倡行HPV基因检测，采取TCT和HPV基因联合检测更能提高术后病变残留或复发的诊断意义。[Objective] To explore the clinical significance of high-risk types of human papillomavirus（HPV） gene and cervical ThinPrep cytology（TCT） detection in the follow up after conization of high-grade squamous intraepithelial lesions（HSIL）. [Methods] There were 80 patients who were hospitalized for HSIL undergoing cervical cold knife conization and retaining the uterus, and had complete data, and were regularly followed up after operation in our hos- pital from Jan. 2009 to Jan. 2012. The residual rate at 3, 4, 5, 6, 12, 18 and 24 months after operation were ana- lyzed and compared. [Results] Among 80 patients, the high-risk HPV-DNA was positive in 18 patients half a year after operation. Colposcopic cervical biopsy suggested cervical intraepithelial neoplasia in 6 patients, and the coinci- dence rate was 33. 3 % （6/18）. TCT showed more than ASC-US lesions in 10 patients. Colposcopic cervical biopsy showed cervical squamous intraepithelial neoplasia in 6 patients, and the coincidence rate was 60% （6/10）, and there was significant difference（ P d0.05）. High-risk HPV-DNA was positive in 16 cases half a year after operation. Col- poscopic cervical biopsy showed cervical squamous intraepithelial neoplasia in 6 patients, and the coincidence rate was 37.5^（6/16）. TCT showed more than ASC-US lesions in 6 patients. Colposcopic cervical biopsy showed cervical squamous intraepithelial neoplasia in 1 patient, and the coincidence rate was 16.7 % （1/6）, and there was significant difference（ P d0.05）. [Conclusion] TCT can be used for screening early cervical lesions in half a year after conization of cervical high-grade squamous intraepithelial neoplasia. HPV gene detection half a year after operation is suggested. The joint detection of TCT and HPV gene can more improve the diagnosis of residual lesion or recurrence after operation.

关 键 词：宫颈疾病 外科学 x乳头状瘤病毒属 

分 类 号：R711.74[医药卫生—妇产科学]