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目的探讨宫颈液基细胞学检查(TCT)报告为性质未定的不典型鳞状细胞(ASCUS)的临床意义及处理。方法对宫颈薄层液基细胞学诊断为ASCUS的1658例患者分别进行HR-HPV检测、阴道镜下活组织检查。结果在ASCUS患者中,HR-HPV阳性组CIN及浸润癌的检出率为68.22%,在HR-HPV阴性组CIN及浸润癌的检出率为8.74%,两组间差异有显著性(P<0.001)。阳性组发生CIN和浸润癌的风险是阴性组的22.4065倍[OR(9%CI)=22.4065]。阴道镜拟诊CIN和浸润癌842例,检出率为88.82%(802/903),其中高级别CIN和浸润癌134例,检出率为87.01%(134/154)。结论阴道镜联合HR-HPV检测在宫颈癌前病变,特别是在高级别宫颈上皮内瘤变及浸润癌诊断中阳性预测值较理想,敏感性较好,漏诊率低,具有较高的推广价值。
Objective To investigate the clinical significance and treatment of cervical cytology-based cytology (TCT) reported as untypical unspecific squamous cell carcinoma (ASCUS). Methods 1658 cases of cervical smear-based cytology ASCUS were detected by HR-HPV, colposcopy biopsy. Results In ASCUS patients, the positive rate of CIN and invasive carcinoma was 68.22% in HR-HPV positive group and 8.74% in CIN and invasive carcinoma of HR-HPV negative group, the difference was significant (P <0.001). The risk of CIN and invasive cancer in the positive group was 22.4065 times more than in the negative group [OR (9% CI) = 22.4065]. Colposcopic diagnosis of CIN and invasive carcinoma 842 cases, the detection rate was 88.82% (802/903), of which 134 cases of high grade CIN and invasive carcinoma, the detection rate was 87.01% (134/154). Conclusion Colposcopy combined with HR-HPV detection in cervical precancerous lesions, especially in the high-grade cervical intraepithelial neoplasia and invasive cancer diagnosis of positive predictive value is better, the sensitivity is good, the rate of missed diagnosis, with a high promotional value .