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目的探讨宫颈液基细胞学(Thinprep cytology test,TCT)结果为不明确意义的不典型鳞状上皮细胞(Atypical Squamous Cell of Undetermined Significance,ASCUS)的病例中高危型人乳头状瘤病毒(HPV)负荷量与宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)病变程度的相关性,说明HPV-DNA检测在ASCUS诊断中的分流作用。方法对2009年1月-2012年11月就诊于我院妇科门诊并经TCT筛查结果为ASCUS,且病理组织学结果为CIN的332例患者,采用杂交捕获二代(HC-2)技术对患者进行HPV-DNA病毒负荷量的检测。检测结果根据病毒负荷量分为低病毒负荷量组(1.00-10.00)、中病毒负荷量组(10.00-100.00)和高病毒负荷量组(≥100),分析HPV-DNA病毒负荷量与CIN病变程度的相关性。结果 332例病理组织学结果为CIN的ASCUS患者中,HPV负荷量呈阳性(>1.00)患者296例,其中低病毒负荷量组29例,占9.80%,中病毒负荷量组58例,占19.59%,高病毒负荷量组209例,占70.61%。低病毒负荷量患者中,中、高程度CIN(HSIL)的患者总计16例,发生率为55.17%;中病毒负荷量患者中有2例鳞癌患者,病理组织学结果为CIN的患者中,中高程度CIN的患者总计34例,发生率为60.71%;高病毒负荷量患者中有4例鳞癌患者,病理组织学结果为CIN的患者中,中高程度CIN的患者总计156例,发生率为76.10%,分布差异显著(P<0.05)。结论在ASCUS病例中,CIN病变程度与HPV-DNA病毒负荷量呈正相关,即HPV-DNA病毒负荷量越高,CIN病变程度越高。
Objective To investigate the risk of high-risk human papilloma virus (HPV) load in case of unspecific Atypical Squamous Cell of Undetermined Significance (ASCUS) with Thinprep cytology test (TCT) The correlation between HPV-DNA levels and the severity of cervical intraepithelial neoplasia (CIN), indicating the diversion of HPV-DNA in the diagnosis of ASCUS. Methods From January 2009 to November 2012, 332 patients with gynecological clinic attending gynecology clinic in our hospital who were diagnosed as ASCUS by TCT and histopathologically as CIN were examined by hybrid capture second generation (HC-2) Patients were tested for HPV-DNA viral load. The detection results were divided into low viral load group (1.00-10.00), moderate viral load group (10.00-100.00) and high viral load group (≥100) according to the viral load, and the relationship between HPV-DNA viral load and CIN Degree of relevance. Results Of the 332 ASCUS patients with histological findings of CIN, 296 were HPV positive (> 1.00), of which 29 were low viral load (9.80%), 58 were moderate viral load (19.59) %, High viral load group of 209 cases, accounting for 70.61%. Among patients with low viral load, a total of 16 patients with medium and high level of CIN (HSIL) were found, accounting for 55.17% of all cases. Among 2 patients with squamous cell carcinoma and 2 patients with pathologically confirmed CIN, A total of 34 patients with high-grade CIN were found in 60 cases (60.71%). Among the patients with high viral load, 4 cases were squamous cell carcinoma and 156 cases were CIN with high-grade CIN. The incidence rate was 76.10%, the distribution difference was significant (P <0.05). Conclusions In the case of ASCUS, the degree of CIN lesion is positively correlated with the load of HPV-DNA virus, that is, the higher the load of HPV-DNA virus, the higher the severity of CIN.