871例人乳头瘤病毒16/18阳性者阴道镜活检结果的回顾性分析  

Retrospective analysis of colposcopy biopsy results in 871 cases of human papillomavirus 16/18 positive patients

作　　者：余桂媛[1] 陈敏杰 闵庆华[3] 贺淑芳[3] YU Gui-yuan;CHEN Min-jie;MIN Qing-hua;HE Shu-fang(Department of Anesthesiology,the First Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330006,China;Department of Clinical Medicine,Queen Mary College,Nanchang University,Jiangxi Province,Nanchang330006,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330006,China)

机构地区：[1]南昌大学第一附属医院麻醉科,江西南昌330006 [2]南昌大学玛丽女王学院临床医学系,江西南昌330006 [3]南昌大学第一附属医院妇产科,江西南昌330006

出　　处：《中国当代医药》2020年第32期8-11,共4页China Modern Medicine

基　　金：江西省教育厅科学技术研究项目(170030)。

摘　　要：目的回顾性分析人乳头瘤病毒(HPV)16/18阳性者液基细胞学(TCT)和阴道镜下活检结果,探讨应用HPV16/18部分分型在子宫颈病变早期诊断中的价值。方法收集2016年1月~2018年1月在南昌大学第一附属医院妇产科因HPV16/18阳性转诊阴道镜行活检的871例患者,收集其年龄、TCT、HPV、病理结果进行统计学分析。结果871例患者活检后,病理结果为宫颈炎469例(53.8%),宫颈上皮内瘤变1级(CIN1)111例(12.7%),CIN284例(9.6%),CIN3124例(14.2%),宫颈癌83例(9.5%)。将HPV16/18阳性者按21~30、>30~40、>40~50、>50岁进行亚分组,其CIN2+病变的比例分别为19.1%(31/162)、28.4%(64/225)、39.1%(109/279)、42.4%(87/205)。HPV16/18阳性且已绝经的患者中,CIN2+病变检出率高于未绝经者(40.4%vs.30.7%),差异有统计学意义(χ^2=7.31,P<0.01)。结论HPV16/18阳性者中CIN2+病变检出率约为33.4%,且随着年龄的增加,CIN2+检出率呈逐渐增高趋势。HPV16/18阳性患者直接转诊阴道镜检查有助于早期发现子宫颈病变。Objective To retrospectively analyze the results of ThinPrep cytologic test(TCT)and colposcopy biopsy of human papillomavirus(HPV)16/18 positive patients,and to explore the value of using HPV16/18 partial typing in the early diagnosis of cervical lesions.Methods Altogether 871 cases of HPV16/18 positive patients who were referred for colposcopy biopsy in the Department of Obstetrics and Gynecology,the First Affiliated Hospital of Nanchang University from January 2016 to January 2018 were collected,and their age,TCT,HPV and the pathological results were collected for statistical analysis.Results Of all the 871 patients included in this study,469 cases(53.8%)were cervical inflammation,111 cases(12.7%)were cervical intraepithelial neoplasia 1(CIN1),84 cases(9.6%)were CIN2,124 cases(14.2%)were CIN3,and 83 cases(9.5%)were cervical cancer.The HPV16/18 positive patients were subgrouped into 21-30,>30-40,>40-50,and>50 years old,and the proportions of CIN2+lesions were 19.1%(31/162)and 28.4%(64/225),39.1%(109/279),42.4%(87/205),respectively.Among the HPV16/18 positive and menopausal patients,the detection rate of CIN2+lesions was higher than that of non-menopausal patients(40.4%vs.30.7%),and the difference was statistically significant(χ^2=7.31,P<0.01).Conclusion The detection rate of CIN2+lesions in HPV16/18 positive patients is about 33.4%,and with the increase of age,the detection rate of CIN2+tends to increase gradually.The immediate transfer of patients to colposcopy whose HPV16/18 shows positive is very helpful to the early detection of cervical lesions.

关 键 词：人乳头瘤病毒 宫颈上皮内瘤变 阴道镜 活检 宫颈癌筛查 液基细胞学 

分 类 号：R737.33[医药卫生—肿瘤]