评估细胞学、HR-HPV在阴道镜检查中发生宫颈癌前病变风险的分层研究

  目的  评估细胞学、高危型人乳头瘤病毒(high risk human papillomavirus, HR-HPV)与阴道镜结果的不同组合发生宫颈上皮内瘤变≥2级(cervical intraepithelial neoplasia grade 2 or worse, CIN2+)的风险。  方法  选取2018年1月-2018年12月深圳市妇幼保健院阴道镜门诊数据库中822例患者的临床数据资料，基于细胞学、HR-HPV和阴道镜结果，分析患者发生CIN2+的风险差异。  结果  若发现其中两种检查结果高度异常(细胞学高度上皮内瘤变及以上(high-grade squamous intraepithelial lesion or worse, HSIL+)、HPV16/18+、阴道镜高级别病变)，则发生CIN2+的风险高于60%；若发现三种高度异常，则发生CIN2+的风险为97.1%。  结论  当发现细胞学、HR-HPV和阴道镜结果中≥2种异常情况，未来进展为CIN2+的风险较高，应予以重视，减少不必要的误诊和漏诊。

Risk stratification study of assessing cervical precancer by cytology,high risk human papillomavirus in colposcopy examination

  Objective  To evaluate pooled risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) based on the various combinations of cytology, HR-HPV (high risk human papillomavirus), and colposcopy impression.  Methods  A total of 822 cases were selected from the colposcopy outpatient database of Shenzhen Maternity & Child Healthcare Hospital from January to December 2018. We assessed the risk of CIN2+ based on the combinations of three test results (cytology, HR-HPV, and colposcopy).  Results  If two of the test results were found highly abnormality (HSIL+, HPV16/18+ and high-grade colposcopic impression), the risks for CIN2+ was higher than 60%. If three highly abnormal test results were found, the risk for CIN2+ was 97.1%.  Conclusio  When at least two abnormal results in cytology HR-HPV and colposcopy are found, the CIN2+ risk was quite high. Attention should be paid to reduce unnecessary misdiagnosis and missed diagnosis.