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目的探讨阴道镜联合HPV-DNA检测对宫颈不典型鳞状细胞的诊断价值。方法选取130例2012年10月至2013年6月于我院妇科门诊经宫颈液基细胞学检查诊断为不典型鳞状上皮细胞(ASCUS)的患者,均行HPV-DNA检测联合电子阴道镜检查和镜下多点活检。结果 130例ASCUS患者中,经病理组织学诊断为慢性炎症87例(66.92%),CIN以上43例(33.08%),其中,CINⅠ11例(8.46%),CINⅡ17例(13.08%),CINⅢ10例(7.69%),鳞癌5例(3.85%)。其中,经HPV-DNA检测阳性者为52例,其中CINI以上共31例(59.62%);HPV-DNA检测阴性者为78例,其中CINI以上共12例(15.38%)。两组CIN检出率差异有统计学意义(P<0.05)。Reid评分3分或以上者34例,其中CINⅡ及以上者为32例(94.12%),而CINⅠ及以下者Reid评分3分或以上者仅4例(36.37%),两者差异有统计学意义(P<0.05)。结论阴道镜联合HPV-DNA检测是进行CIN筛查的有效手段,对及早发现宫颈及癌前病变、降低宫颈癌的发生具有重要的临床意义。
Objective To investigate the value of colposcopy combined with HPV-DNA in the diagnosis of cervical atypical squamous cell. Methods A total of 130 patients diagnosed as atypical squamous cell carcinoma (ASCUS) from gynecological clinic in our hospital from October 2012 to June 2013 were selected for HPV-DNA test combined with electronic colposcopy And multi-point microscopic biopsy. Results Of the 130 ASCUS patients, 87 (66.92%) were diagnosed as chronic inflammation by histopathology and 43 (33.08%) by CIN, of which 11 cases (8.46%) were CINⅠ, 17.08% 7.69%), squamous cell carcinoma in 5 cases (3.85%). Among them, 52 cases were positive by HPV-DNA test, of which 31 cases (59.62%) were positive for CINI and 78 cases were negative for HPV-DNA test, of which 12 cases (15.38%) were positive for CINI. There was a significant difference in the detection rate of CIN between the two groups (P <0.05). There were 34 cases with Reid score of 3 points or more, 32 cases (94.12%) with CINⅡand above, while only 4 cases (36.37%) with Reid score of 3 points or more in CINⅠand below, the difference was statistically significant (P <0.05). Conclusion Colposcopy combined with HPV-DNA testing is an effective method for CIN screening, which has important clinical significance for early detection of cervical and precancerous lesions and reduction of cervical cancer.