目的:探讨高危型HPV检测对ASCUS患者的分类作用及其与年龄的关系。方法:对宫颈细胞学报告为ASCUS的1 016例患者进行高危型HPV检测及阴道镜下宫颈活检。结果:在1 016例ASCUS患者中,慢性宫颈炎696例,CINⅠ154例、CINⅡ72例、CINⅢ74例、宫颈癌20例。HPV阳性430例,其中高级别病变及其以上病变(简称高级别病变)共144例,占35.73%;HPV阴性613例,其中高级别病变22例,占3.59%,未发现宫颈癌。以组织病理学为确诊标准,HPV检测高级别病变的灵敏度、特异度、阳性预测值、阴性预测值分别为35.73%、96.41%、64.68%和3.59%。各年龄段HPV感染率及高级别病变发病率比较均无统计学差异(P>0.05);HPV阳性组与阴性组比较,高级别病变发病率在≥61岁女性中无统计学差异(P>0.05),其他年龄段发病率阳性组明显高于阴性组(P<0.05);HPV阳性组中≥61岁年龄段高级别病变发病率明显低于其他年龄段(P<0.05);HPV阴性组中各年龄段发病率无统计学差异(P>0.05)。结论:对于≤30岁的ASCUS患者也要进行必要的检查或严密的随访,HPV检测可作为≤60岁ASCUS患者有效、准确的分流措施。 Objective: To investigate the classification of high-risk HPV in ASCUS patients and its relationship with age. Methods: A total of 1 016 patients with cervical cytology reported as ASCUS underwent high-risk HPV test and colposcopic cervical biopsy. Results: Among 1 016 ASCUS patients, 696 cases were chronic cervicitis, including 154 cases of CINⅠ, 72 cases of CINⅡ, 74 cases of CINⅢ and 20 cases of cervical cancer. There were 430 cases of HPV positive, including 144 cases (35.73%) with high-grade lesions and above lesions, and 613 cases with HPV-negative lesions (22 cases, accounting for 3.59%). No cervical cancer was found. The sensitivity, specificity, positive predictive value and negative predictive value of high-grade HPV lesions were 35.73%, 96.41%, 64.68% and 3.59%, respectively, using histopathology as the diagnostic criteria. There was no significant difference in the incidence of HPV infection among all age groups and the incidence of high-grade lesions (P> 0.05). Compared with the negative group, the incidence of high-grade lesions in the HPV positive group was not significantly different among women aged> 61 years (P> 0.05). The incidence of other age groups was significantly higher than that in the negative group (P <0.05). The incidence of high grade lesions in the group of HPV positive was significantly lower than that in other age groups (P <0.05) There was no significant difference in all age groups (P> 0.05). CONCLUSIONS: Necessary examinations or close follow-up are also required for ASCUS ≤30 years of age. HPV testing can be an effective and accurate bypass measure for ASCUS in patients ≤60 years.