绝经期女性宫颈细胞学ASCUS和LSIL的分层管理方案探讨  

Discussion on the stratified management scheme of cervical cytology ASCUS and LSIL in menopausal women

作　　者：王丛 陈哲 效小莉 WANG Cong;CHEN Zhe;XIAO li-Xiao(Space Center Hospital,Beijing 100089,China)

机构地区：[1]航天中心医院,北京100089

出　　处：《中国国境卫生检疫杂志》2022年第S01期80-82,共3页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的探讨绝经期女性液基薄层细胞学检查(Thinprep Cytology Test,TCT)提示ASCUS和LSIL的分层管理方案。方法选取2017年2月-2022年2月在航天中心医院因“宫颈细胞学提示ASCUS或LSIL”转诊行阴道镜的自然绝经妇女241例为研究对象。年龄49~77岁,平均(59.2±4.9)岁。进行TCT及HPV分型检测,并均行阴道镜检查及宫颈活检,将病理诊断M宫颈上皮内瘤变(CIN)II者视为病理检查阳性,病理诊断≤CIN 1者视为阴性。以病理诊断为宫颈病变的“金标准”,分析HPV分型检测作为细胞学ASCUS和LSIL分层管理的可行性。结果HPV高危型检测诊断绝经期ASCUS/LSIL患者宫颈高级别病变的灵敏度为83.87%,特异度为38.57%,阳性预测值为16.77%,阴性预测值为94.19%。结论HPV高危型检测可作为绝经期女性宫颈细胞学AUCUS及LSIL患者分层管理的手段,有较高的阴性预测值,可有效减少转诊阴道镜的概率。Objective To explore the layered management of Thinprep Cytology Test(TCT)in menopausal women suggesting ASCUS and LSIL.Methods From February 2017 to February 2022,241 natural menopausal women who underwent colposcopy were referred to"cervical cytology suggests ASCUS or LSIL"in the Aerospace Center Hospital as the study subjects.Age 49~77 years old,average(59.2±4.9)years.TCT and HPV typing tests,colposcopy and cervical biopsy were performed,and those with pathological diagnosis M cervical intraepithelial neoplasia(CIN)Il were regarded as positive for pathological examination and negative for pathological diagnosis ≤ CINI.Taking pathological diagnosis as the"gold standard"for cervical lesions,the feasibility of HPV typing assay as a stratified management of cytology ASCUS and LSIL was analyzed.Results The sensitivity of HPV high-risk detection for the diagnosis of high-grade cervical lesions in menopausal ASCUS/LSIL patients was 83.87%,the specificity was 38.57%,the positive predictive value was 16.77%,and the negative predictive value was 94.19%.Conclusion HPV high-risk detection can be used as a means for the stratified management of cervical cytology AUCUS and LSIL patients in menopausal women,and has a high negative predictive value,which can effectively reduce the probability of referral to colposcopy.

关 键 词：液基细胞学检查 高危型人乳头瘤病毒 绝经期女性 宫颈上皮内瘤变 

分 类 号：R183[医药卫生—流行病学]