宫颈非典型鳞状细胞198例临床分析  

Clinical analysis of 198 cases of cervical atypical squamous cells

作　　者：程大梅 朱春芳 

机构地区：[1]荆门市第二人民医院,湖北荆门448000 [2]荆门市中医医院,湖北荆门448000

出　　处：《基层医学论坛》2015年第16期2167-2169,共3页The Medical Forum

摘　　要：目的：探讨宫颈细胞学检查为意义不明确的非典型鳞状细胞（ASCUS）进一步处理的临床路径。方法对198例宫颈细胞学检查诊断为ASCUS的患者，联合采用PCR-反向杂交法进行人乳头状瘤病毒（HPV）基因检测及分型和阴道镜检查及镜下活组织检查。结果 ASCUS主要分布在31岁~50岁年龄段，HPV基因检测及分型检查共检出62例阳性者，感染率为31.31%，HPV高危亚型的感染率≤30岁组与41岁~55岁组明显高于31岁~40岁组，为2个明显的高峰期。198例ASCUS中包含各种宫颈病变，具体组织学检查结果为：炎症158例（79.80%），CINⅠ级30例（15.15%），CINⅡ级3例（1.52%），CINⅢ级4例（2.02%），原位癌2例，浸润癌1例，共3例（1.52%）。HPV阳性患者中的宫颈CIN及以上病变检出率显著高于HPV阴性患者。结论对宫颈细胞学检查为ASCUS的患者，应联合HPV基因检测及分型和阴道镜下活组织检查，以提高宫颈病变筛查的阳性率。Objective To investigate the cervical cytology is ambiguous atypical squamous cells（ASCUS）of clinical pathway for further processing. Methods 198 cases of cervical cytology in patients diagnosed with ASCUS, combined with human papilloma virus by PCR-reverse dot blot （HPV） gene detection and typing and vaginoscopy and pathologic biopsy. Results ASCUS was mainly distributed in the 31-50 age,HPV gene detection and typing examination were detected positive in 62 cases,the infection rate was 31.31%, high-risk subtypes of HPV infection rate is less than or equal to 30 years old group and 41~55 years old group was higher than that of 31~40 years old group ,2 obvious peak. In 198 cases of ASCUS contains a variety of cervical lesions, the specific histology results for：inflammation in 158 cases（79.80%）,30 cases of CIN I（15.15%）, 3 cases with CIN II（1.52%）,4 cases of CIN III（2.02%）,2 cases of carcinoma in situ, invasive carcinoma in 1 cases,3 cases （1.52%）. Detection rate of HPV in patients with positive cervical CIN and above lesions were significantly higher than that of HPV negative patients. Conclusion the cervical cytology with ASCUS should be combined with detection of HPV gene and type and biopsy under colposcope,to increase the positive rate of screening for cervical lesions.

关 键 词：ASCUS HPV检测 阴道镜 活组织检查 

分 类 号：R737.33[医药卫生—肿瘤]