不典型鳞状细胞(ASC)在子宫颈病变中的诊断价值

目的:探讨不典型鳞状细胞(ASC)在子宫颈病变中的诊断价值。方法:对TCT诊断为不典型鳞状细胞(ASC)336例患者同时行HC2-HPV-DNA检测及阴道镜下活组织检查。结果:炎性反应152例(45.2%),HPV感染86例(25.6%),轻度不典型增生(CINⅠ)29例(8.6%),中度不典型增生(CINⅡ)35例(10.4%),重度不典型增生(CINⅢ)28例(8.3%),宫颈癌6例(1.8%)。ASC-H与ASC-US相比,宫颈HPV感染以上病变及HC2-HPV-DNA阳性率明显增高,差异有统计学意义(P<0.01)。ASC-US中,HC2-HPV-DNA阳性者,宫颈HPV感染及CIN发生率明显增高,差异有统计学意义(P<0.01)。结论:对不典型鳞状细胞,属意义不明者(ASC-US),应常规行HC2-HPV-DNA检测,如HC2-HPV-DNA阳性者,应进一步行阴道镜下宫颈活检。对不典型鳞状细胞,未能除外高度上皮内病变者(ASC-H),应予高度重视,行阴道镜下宫颈活检,以提高宫颈癌及CIN的检测率。

Clinical importance of ASC in the diagnosis of cervical intraepithelial neoplasia

Objective To investigate the significance of ASC in cervical intraepithelial neoplasia.Method HC2-HPV-DNA as well as colposcopy was applied on 336 cases with the diagnosis of ASC by TCT.Results 152 cases(45.2%) were found to be inflammation reaction,86 cases(25.6%) with HPV infection,29 cases(8.6%)with CIN I,35 cases(10.4%)with CIN II,28 cases(8.3%)with CIN III,6 cases(1.8%) with cervical carcinoma.Patients with ASC-H showed higher HC2-HPV-DNA positive rate,with statistically significance.Conclusion In order to improve the diagnosis of cervical carcinoma and CIN,patients of ASCUC in cervical smear examination should routinely apply HC2-HPV-DNA test.If a positive result was confirmed,colposcopy and biopsy should be taken as a further examination.Those of ASC-H should be highly emphasized and undertake colposcopy and biopsy.