宫颈细胞学ASC-US高危HPV阳性患者宫颈病变的结果分析  

Analysis on Cervical Lesions in High-risk Human Papillomavirus Positive Women with ASC-US

作　　者：袁静 陈柳 党颖慧 蔡浩昱 李佳 杨红 YUAN Jing;CHEN Liu;DANG Ying-hui(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Air Force Medical University,Shaanxi 710032,China)

机构地区：[1]空军军医大学第一附属医院妇产科,西安710032

出　　处：《医学研究杂志》2022年第7期81-84,共4页Journal of Medical Research

基　　金：陕西省重点研发计划项目(2020GXLH-Y-009)。

摘　　要：目的 探讨宫颈细胞学为非典型鳞状上皮细胞意义不明确(ASC-US)合并高危型人乳头瘤病毒(hr-HPV)阳性患者,HPV亚型分布及宫颈病变的情况。方法 回顾性分析2020年6~11月来笔者医院就诊的176例提示细胞学ASC-US,hr-HPV阳性,且行阴道镜下宫颈活检组织病理的患者资料。利用SPSS 26.0统计学软件进行统计分析hr-HPV基因型与宫颈高级别鳞状上皮内病变(HSIL)及宫颈鳞癌检出率之间的关系。结果 176例ASC-US患者中,89例LSIL,30例HSIL,6例SCC,HSIL+检出率为20.45%;hr-HPV亚型检出率位于前6位的是HPV16、52、58、53、59、18,并且HPV16亚型在各年龄段感染率最高,其次为52型、58型;HSIL+患者主要以16/18单一型感染为主(χ^(2)=28.283,P<0.01),混合型感染hr-HPV的HSIL+检出率以含16/18型的多重感染为主,分别为30%和20%。结论 细胞学ASC-US患者,HPV16、52、58型在各年龄段感染率较高;感染HPV16/18亚型时,HSIL+检出率更高。同时,也需要关注其他高危亚型感染,防止HSIL+患者漏诊。Objective To investigate high-risk HPV(hr-HPV) genotype distributions and the association between hr-HPV infection with severity of the cervical lesions in women with atypical squamous cells of undetermined significance(ASC-US) cytology.Methods A total of 176 patients with ASC-US and hr-HPV positive underwent colposcopy cervical biopsy.The results were analyzed for the relationship between hr-HPV genotype and high-grade squamous intraepithelial lesion(HSIL) and squamous cell carcinoma by SPSS 26.0.Results 176 hr-HPV-positive/ASC-US women were enrolled in this study.Overall,89 cases were LSIL and 30 cases were HSIL,and 6 cases were SCC.The rate of HSIL or worse(HSIL+) in women was 20.45%.The detection rate of hr-HPV in women with single HPV16 infection was the highest,followed by 52,58,53,59,18,and the infection rate of HPV16 was the highest in all age groups,followed by 52 and 58.Single 16 or 18 type infection was predominant in HSIL+ patients(χ~2=28.283,P<0.01),and the detection rate of HSIL+ of mixed hr-HPV was mainly multiple infections containing 16/18(30% and 20%,respectively).Conclusion The infection rate of HPV16,52,58 was higher in all ages and the detection rate of HSIL+was higher in ASC-US patients infected with HPV16/18 subtype.At the same time,we should pay attention to other high-risk subtypes to prevent HSIL+patients from missing diagnosis.

关 键 词：非典型鳞状上皮细胞意义不明确 高危型人乳头瘤病毒 液基细胞学 宫颈上皮内病变 鳞癌 高级别鳞状上皮内病变 

分 类 号：R737.33[医药卫生—肿瘤]