对宫颈不典型鳞状细胞患者临床分流处理的研究  

Exploring in management of women with atypical squamous cells of undetermined significance

作　　者：孙玲玲[1] 王美丽[2] 王慧琴[2] 王丽娜[2] 

机构地区：[1]潍坊市妇幼保健院,261011 [2]吉林大学第一医院,长春市130021

出　　处：《实用医学杂志》2014年第20期3296-3298,共3页The Journal of Practical Medicine

基　　金：吉林省科技厅国际合作项目(编号:20120735);吉林大学基本科研业务经费(编号:450060481606)

摘　　要：目的：探讨宫颈细胞学诊断为不典型鳞状细胞（ASCUS）患者的分流处理方法。方法：对130例ASCUS患者均进行高危型HPV检测、改良阴道镜Reid评分及宫颈活检组织病理学检查。结果：130例ASCUS患者中病理结果为正常或炎症31例（23．90％），CINⅠ级29例（22．30％），CINⅡ级14例（10．80％），CINⅢ级或原位癌55例（42．30％），浸润癌1例（0．80％）。改良阴道镜Reid评分，结果显示0分32例（24．60％），1～2分36例（27．70％），3～4分47例（36．10％），5～6分15例（11．60％）。改良阴道镜Reid评分检测ASCUS中CIN及宫颈癌的敏感性为98．99％（98／99），特异性为51．61％（16／31）。 hr-HPV检测ASCUS中CIN及宫颈癌的敏感性为96．97％（96／99），特异性为32．26％（10／31）。结论：改良阴道镜Reid评分与hr-HPV检测均可用于分流ASCUS中的CIN及宫颈癌患者，但改良阴道镜Reid评分在敏感性和特异性方面均优于hr-HPV检测。Objective Exploring in processing method to triage of women with a cytologic smear showing atypical squamous cells of undetermined significance. Methods All 130 cases were diagnosed with ASCUS received high-risk HPV （hr-HPV）test, colposcopic inspections, reformeded Reid＆#39;s colposcopic index score and cervical biopsies for pathological examination. Resluts The pathology of 130 ASCUS patients included 31cases of normal and inflammation （23.90%）, 29 cases of CINⅠ（22.30%）, 14 cases of CINⅡ（10.80%）, 55 cases of CINⅢ or cervical carcinoma in situ （42.30%）, and 1 case of invasive cervical carcinoma （0.80%）. The reformed Reid＆#39;s colposcopic index score of 130 ASCUS patients included 32 cases of 0 score （24.60%）, 36 cases of 1~2 scores （27.70%）, 47 cases of 3~4 scores（36.10%）, 15 cases of 5~6 scores（11.60%）. 2. The colposcopy used to detect the CIN of ASCUS, its sensitivity was 98.99%（98/99）, specificity was 51.61%（16/31）. The hr-HPV used to detect the CIN of ASCUS, its sensitivity was 96.97%（96/99）, specificity was 32.26%（10/31）. Conclusion Both the reformeded Reid′s colposcopic index score and hr-HPV testing as the clinical triage methods of ASCUS. The former has good sensitivity and specificity ,which is superior to hr-HPV testing.

关 键 词：宫颈不典型鳞状细胞 宫颈癌 人乳头瘤病毒 分流 REID评分 

分 类 号：R737.33[医药卫生—肿瘤]