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目的评价宫颈细胞学检查、人乳头瘤病毒(HPV)-DNA检测联合阴道镜检查对子宫颈病变的诊断价值,探讨性质未定的不典型鳞状细胞(ASCUS)的临床处理方法。方法对经宫颈脱落细胞检查学诊断为ASCUS的90例患者行人HPV检测及阴道镜下多点活检。结果 90例ASCUS患者中,宫颈上皮内瘤变(CIN)及宫颈癌的发生率为31.11%(28/90),HPV阳性率为43.33%(39/90)。高危HPV阳性组CIN以上检出率为51.28%(20/39),HPV阴性组中CIN以上检出率为15.69%(8/51)。高危HPV阳性患者中以高危HPV16、HPV52、HPV58、HPV18、HPV33最多见。结论应加强对ASCUS患者的重视,尤其是合并高危HPV感染的患者,液基细胞学检查、HPV-DNA检测联合阴道镜检查能提高宫颈病变的检出率。
Objective To evaluate the diagnostic value of cervical cytology, human papillomavirus (HPV) -DNA and colposcopy in the diagnosis of cervical lesions and to explore the clinical treatment of untypical unscheduled squamous cell carcinoma (ASCUS). Methods Ninety patients diagnosed ASCUS by cervical exfoliative cytology were tested for HPV and multi-biopsy under colposcopy. Results Among 90 ASCUS patients, the incidence of cervical intraepithelial neoplasia (CIN) and cervical cancer was 31.11% (28/90), and the positive rate of HPV was 43.33% (39/90). The detection rate of CIN in high risk HPV positive group was 51.28% (20/39), and that of HPV negative group was 15.69% (8/51). High-risk HPV-positive patients with high-risk HPV16, HPV52, HPV58, HPV18, HPV33 most common. Conclusions The ASCUS patients should be emphasized, especially in patients with high-risk HPV infection. Liquid-based cytology and HPV-DNA combined with colposcopy can improve the detection rate of cervical lesions.