高危人乳头状瘤病毒检测对TCT异常的辅助作用

目的:探讨高危人乳头状瘤病毒(HPV)检测对薄层液基细胞学检测(TCT)结果异常者诊断的辅助作用。方法:对139例TCT检查结果异常的[其中未明确意义的不典型鳞状细胞(ASCUS)120例,低度鳞状上皮内病变(LSIL)17例,高度鳞状上皮内病变(HSIL)2例]患者进行HPV检测、阴道镜下宫颈活检。结果:①120例TCT提示ASCUS的患者中,HSIL 28例,检出率为23.3%;HSIL中高危HPV检出25例,检出率89.3%(25/28);低危HPV阳性及HPV阴性检出3例,检出率10.7%(3/28);高危HPV阳性者中HSIL检出25例,检出率为41%(25/61);低危HPV阳性及HPV阴性患者中HSIL为5%(3/59),并且均为CINⅡ期,统计学分析显示差异显著(P<0.05)。②17例TCT检测出的LSIL患者中,HSIL 9例,检出率为52.9%,均为高危HPV阳性者。③TCT检查HSIL患者2例,HPV高危型均阳性,病检提示均为宫颈鳞状细胞癌。结论:高危HPV检测能够对TCT结果异常患者进行确诊和鉴别,从而为后期的临床处理起到很好的指导作用。

Auxiliary Detection of High Risk Human Papillomavirus Virus in TCT Abnormal Patients

Objective:To explore the identification value of high risk human papillomavirus(HPV)test in the patients with abnormal result of thin-prep cytologic test(TCT).Methods:HPV assay and biopsy examination were used to identify the 139patients with abnormal TCT test,including 120 cases of atypical squamous cells of undetermined significance(ASCUS),17cases of low-grade squamous intraepithelial lesion(LSIL),and 2cases of high-grade squamous intraepithelial lesion(HSIL).Results:Among the 120ASCUS cases,28were found having cervical HSIL,with a ratio of 23.3%.Of the 28HSIL patients suggested by TCT,25were high risk HPV positive,with a ratio of 89.3%(25/28),and 3cases were low risk HPV positive and HPV negative,with a ratio of 10.7%(3/28).Among the high risk HPV positive patients,25cases were found with HSIL,with a ratio of 41%(25/61).Among the low risk HPV positive and HPV negative patients,only 3cases were found with HSIL,and all were in CINⅡphase,with a positive ratio of 0.05%(3/59).The statistical analysis showed that the HSIL positive patients ratio between high risk HPV patients and low risk or negative HPV patients was significantly different(P< 0.05).Among the 17LSIL patients suggested by TCT,9cases are diagnosed with HSIL by biopsy examination,with a positive ratio of 52.9%,and all were HPV positive.Two HSIL patients suggested by TCT showed positive HPV result,and biopsy examination determined the lesion were cervical squamous cell carcinoma(CSCC).Conclusion:High risk HPV test is of clinical value for identification and diagnosis for patients with abnormal TCT results.