宫颈液基细胞学ASC-US患者病理特征及相关危险因素分析  

Analysis of pathological characteristics and related risk factors in patients with ASC-US by cervical liquid-based cytology

作　　者：程强 何莲芝[1] CHENG Qiang;HE Lianzhi(Department of Obstetrics and Gynecology,Yijishan Hospital,Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院弋矶山医院妇产科,安徽芜湖241001

出　　处：《沈阳医学院学报》2022年第2期133-136,共4页Journal of Shenyang Medical College

基　　金：皖南医学院中青年科学项目(No.WK2020F05)。

摘　　要：目的:分析宫颈液基细胞学检查结果为未明确意义的不典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASC-US)患者的病理特征及相关危险因素,探讨ASC-US患者的分流管理。方法:回顾性分析2019年9月至2021年1月在我院妇科就诊行宫颈液基细胞学检查结果ASC-US的194例患者的临床资料,患者均行HPV分型检测及组织病理学检查,分析患者的病理特征及相关危险因素。结果:194例患者中,慢性宫颈炎132例,低级别鳞状上皮内病变(low grade squamous intraepithelial lesion,LSIL)11例,高级别鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)42例,宫颈癌9例。将慢性宫颈炎及LSIL患者列为≤LSIL病变组,HSIL及宫颈癌患者列为≥HSIL病变组,2组患者在孕次、流产次数、避孕方式、HPV感染和高危HPV分型比较差异均有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,孕次>2次、不使用避孕套避孕、有HPV感染和HPV高危型感染均为ASC-US发生HSIL及以上病变的高危因素。结论:高危型HPV检测是ASC-US患者分流的重要指标,孕次>2次、不使用避孕套避孕、HPV高危型感染均为ASC-US患者发生HSIL及以上病变的高危因素。ASC-US患者应基于病变风险个性化评估,有助于建立有效的分流管理策略。Objective:To analyze the pathological characteristics and related risk factors of atypical squamous cells of undetermined significance(ASC-US)diagnosed by the cervical liquid-based cytology,and to explore the shunt management of ASC-US patients.Methods:The clinical data of 194 patients with ASC-US diagnosed by the cervical liquid-based cytology in our hospital from Sep 2019 to Jan 2021 were retrospectively analyzed.All patients underwent HPV typing detection and histopathological examination,and their clinical pathological data and characteristics and related risk factors were analyzed statistically.Results:Among the 194 patients,there were 132 cases of chronic cervicitis,11 cases of low grade squamous intraepithelial lesion(LSIL),42 cases of high grade squamous intraepithelial lesion(HSIL),and 9 cases of cervical cancer.The patients with chronic cervicitis and LSIL were classified as≤LSIL lesion group,and the patients with HSIL and cervical cancer were classified as≥HSIL lesion group.Univariable analysis showed that there were statistically significant differences in gravidity,number of abortions,methods of contraception,HPV infection and classification between the two groups(P<0.05).Multivariable analysis showed that gravidity>2,not-use of condoms,HPV infection and high-risk HPV infection were the high risk factors for the occurrence of≥HSIL lesions in ASC-US.Conclusions:High-risk HPV is an important indicator of shunt in ASC-US patients,gravidity>2,not-use of condoms and high-risk HPV infection were high risk factors for the occurrence of≥HSIL lesions in ASC-US patients.The personalized assessment of disease risk should be performed in ASC-US patients,so as to establish an effective shunt management strategy.

关 键 词：液基细胞学检查 未明确意义的不典型鳞状上皮细胞 高危型人乳头瘤病毒 宫颈上皮内瘤变 

分 类 号：R711[医药卫生—妇产科学]