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目的探讨液基细胞学检查(TCT)结果为宫颈不典型鳞状上皮细胞(ASCUS)的诊疗处理方案。方法随机抽取400例ASCUS患者,平均分为两组,一组于3个月后复查TCT,后行HR-HPV DNA检测和阴道镜检查;另一组即刻行HR-HPV DNA检测和阴道镜检查,比较3个月后复查TCT、HR-HPV DNA检测、阴道镜及镜下活检三种方法对ASCUS患者管理的临床诊治意义。结果①A组复查TCT,124例细胞异常者阴道镜下活检病理为宫颈癌1例,CIN II~III级31例,CIN I级48例,慢性宫颈炎44例,76例细胞正常者阴道镜下活检病理为CIN II~III级1例,CIN I级2例,慢性宫颈炎73例。②A组行HR-HPV DNA检测,结果 132例阳性患者中,宫颈癌1例,CIN II~III级32例,CIN I级50例,慢性宫颈炎49例,68例阴性患者的病理结果均为慢性炎症。③B组HR-HPV DNA检测结果 121例阳性患者中CIN II~III级44例,CIN I级50例,慢性宫颈炎27例,79例阴性患者的病理结果均为慢性炎症。结论采用个性化处理,本文倾向于在各方面条件允许的情况下,首选HR-HPV DNA检测分流,对阳性结果患者进行阴道镜下活检或诊断性LEEP。
Objective To investigate the diagnosis and treatment of cervical atypical squamous cell (ASCUS) by liquid-based cytology (TCT). Methods A total of 400 ASCUS patients were randomly divided into two groups. One group received TCT after 3 months and HR-HPV DNA and colposcopy were performed. The other group received HR-HPV DNA test and colposcopy immediately The clinical significance of TCT, HR-HPV DNA test, colposcopy and endoscopic biopsy in the management of ASCUS was compared between three months later. Results (1) The TCA was retrospectively reviewed in 124 patients with colorectal cancer. Colposcopy biopsy showed that the colposcopic biopsy was 1 case of cervical cancer, 31 cases of CIN II ~ III, 48 cases of CIN I, 44 cases of chronic cervicitis and 76 cases of normal cell under colposcopy Biopsy pathology was CIN II ~ III in 1 case, CIN I in 2 cases, chronic cervicitis in 73 cases. ②A group of HR-HPV DNA test results, 132 cases of positive patients, cervical cancer in 1 case, CIN II ~ III 32 cases, CIN I 50 cases, chronic cervicitis 49 cases, 68 cases of negative patients pathological results were Chronic inflammation. ③B group HR-HPV DNA test results of 121 cases of positive patients CIN II ~ III 44 cases, CIN I grade 50 cases, chronic cervicitis 27 cases, 79 cases of negative patients pathological results are chronic inflammation. Conclusions With individualized treatment, this article prefers HR-HPV DNA to detect shunting in cases where conditions permit, and colposcopic biopsy or diagnostic LEEP for positive patients.