ASCUS/HR-HPV阳性者HSIL危险因素分析  

Analysis of Risk Factors of High Grade Squamous Intraepithelial Lesion of the Patients with Positive ASCUS/HR-HPV

作　　者：吴敏霞 尤志学[1] 何晓明 钱晓月 邢燕[1] 周斌兵[1] WU Minxia;YOU Zhixue;HE Xiaoming;QIAN Xiaoyue;XING Yan;ZHOU Binbing(Department of Gynecology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Gynecology and Obstetrics,Wuxi Maternal and Child Healthcare Hospital,Wuxi 214002,China)

机构地区：[1]南京医科大学第一附属医院妇科,南京210029 [2]无锡市妇幼保健院妇产科,江苏无锡214002

出　　处：《医学综述》2018年第10期1961-1964,共4页Medical Recapitulate

摘　　要：目的探讨不能明确意义的非典型鳞状上皮细胞/高危型人乳头瘤病毒(ASCUS/HR-HPV)阳性者中发生相关宫颈高度鳞状上皮内病变(HSIL)的危险因素。方法通过对2014年8月至2015年8月在南京医科大学第一附属医院就诊的91例ASCUS/HR-HPV阳性者阴道镜指引下宫颈活检组织病理回顾分析,探讨ASCUS/HR-HPV阳性中HSIL的风险因素。结果 91例ASCUS/HR-HPV阳性者中16例诊断为HSIL。单因素分析:不同HR-HPV型别间HSIL发生率差异有统计学意义(P<0.05),HPV16/18型HSIL发生率显著高于其他12型(P<0.001),患者年龄及HR-HPV负荷量的高低HSIL发生率差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示:HPV16/18是影响HSIL的危险因素(OR=7.481,95%CI 2.306~24.267,P=0.001)。结论 HPV16/18阳性是ASCUS/HR-HPV阳性者发生HSIL的危险因素,应结合阴道镜评估,选择分层处理。Objectives To analyze the relevant risk factors for high-grade squamous intraepithelial lesion（ HSIL） in patients with positive atypical squamous cell of undetermined significance/high risk human papillomavirus（ ASCUS/HR-HPV）. Methods A retrospective study was performed on 91 ASCUS/HR-HPV positive cases int the Department of Obstetrics and Gynecology,the First Affiliated Hospital of Nanjing Medical University,between Aug. 2014 and Aug. 2015.All patients underwent coloscopy-guided biopsy,to analyze the risk factors of HSIL in patients with positive ASCUS/HR-HPV. Results Among the 91 ASCUS/HR-HPV positive cases,16 cases were diagnosed with HSIL. Univariate analysis showed that different HPV genotypes showed various HSIL rates（ P〈0. 05）,HSIL rates in HPV16/18 were significant higher than the other 12 genotypes（ P〈0. 001）. Age of the patient and load of HR-HPV didn＇ t result in different HSIL incidences（ P〈0. 05）. Multivariable Logistic analysis found that only HPV genotype was associated with diagnosis of HSIL（ OR = 7. 481,95% CI 2. 306-24. 267,P = 0. 001）. Conclusion HPV16/18 positive is a risk factor for HSIL associated with patients with positive ASCUS/HR-HPV. It should be combined with colposcopy to select stratified treatment.

关 键 词：不能明确意义的非典型鳞状上皮细胞 人乳头瘤病毒 病毒分型 病毒载量 宫颈高度鳞状上皮内病变 

分 类 号：R711.74[医药卫生—妇产科学]