HPV分型检测在分流诊治ASCUS病例中的临床意义

目的探讨HPV检测在分流宫颈细胞学检查为ASCUS病例的临床意义及应用价值。方法 2011年7月至2012年7月,对211例细胞学检查为ASCUS的患者检测HPV感染类型,同时行阴道镜检查。结果①211例ASCUS中,108例为HPV阳性,其中高危型感染的102例。②阴道镜结果为宫颈炎症129例,宫颈湿疣及CINI55例,CINII-III26例,宫颈鳞癌1例。③高危型HPV阳性组中炎症35例、宫颈湿疣及CINI41例、CINII及以上病变26例,病变检出率为65.7%,CINII及以上病变检出率为25.5%。HPV阴性组中炎症、宫颈湿疣及CINI、CINII及以上病变分别为89例、13例、1例,病变检出率为13.8%,CINII及以上病变检出率为0.92%。二组之间病变检出率(χ2=58.192,P=0)及CINII及以上病变检出率差异具有统计学意义(χ2=26.942)。低危型HPV感染主要为炎症,仅发现1例低级别病变。利用高危型HPV检测ASCUS患者CIN及宫颈癌的阳性预测值为0.66,阴性预测值为0.86。④高危型HPV16、18感染对象和其他高危型HPV感染组在病变检出率上比较无统计学差异(χ2=2.995,P=0.084),二组之间CINII及以上病变检出率差异有统计学意义(χ2=12.237)。结论 HPV检测是分流ASCUS患者的有效方法,对高危型HPV感染的ASCUS患者,再进一步行阴道镜检查是较好的分流处理。高危型HPV感染的ASCUS患者HPV分型具有一定指导意义。

Clinical Value of HPV DNA Test in Patients with TCT Indicating ASCUS

Objective To investigate the clinical value of HPV DNA test in patients with TCT indicating ASCUS.Methods 211 women with TCT indicatingASCUS were enrolled from July 2011 to July 2012,following biopsy with colposcopy for pathological diagnosis.Results ①211 cases ofASCUS,108 were positive for HPV high-risk infection 102 cases.②colposcopy results of 129 cases of cervical inflammation,cervical warts and CINI55 of cases,CINII-III26 cases of cervical squamous cell carcinoma patients.③high-risk HPV-positive group,35 cases of inflammation the cervical warts and CINI41 of cases the CINII and more severe lesions in 26 cases,the lesion detection rate of 65.7%,CINII and above lesion detection rate of 25.5%.Inflammation,cervical condyloma and CINI,CINII and more severe lesions in the HPV-negative group were 89 cases,13 cases,1 case,the lesion detection rate of 13.8%,CINII and above lesion detection rate of 0.92%.The lesion detection rate between the two groups（χ2 = 58.192,P = 0） and CINII and the above lesion detection rate difference was statistically significant（χ2= 26.942）.Low-risk HPV infection,inflammation,and only found one case of low-grade lesions.The use of high-risk HPV testing in patients with ASCUS,CIN and cervical cancer,the positive predictive value of 0.66 and a negative predictive value of 0.86.④ high-risk HPV16,18 infected objects and other high-risk HPV infection in the lesion detection rate was no statistically significant difference（χ2= 2.995,P = 0.084） between the two groups CINII and above lesion detection rate difference was statistically significance（χ2= 12.237）.Conclusions HPV-DNA test is of practical value in further screening patients with ASCUS following TCT,and HR-HPV infection strongly suggests biopsy in colposcopy in case of lesions in higher levels