高危型人乳头状瘤病毒检测在宫颈上皮内瘤变筛查中的价值

目的:探讨高危型人乳头状瘤病毒(high-risk human papillomavirus,HR-HPV)检测在宫颈癌及癌前病变筛查中的价值。方法:对2010年1月—2012年10月上海市普陀区人民医院妇科门诊宫颈薄层液基细胞学(thinprep cytologic test,TCT)检查阳性者195例行HR-HPV检测及宫颈多点活检病理检查。结果:TCT检查为意义不明的不典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)155例,其中HR-HPV阳性者宫颈活检阳性率为30.0%(18/60),高于HR-HPV阴性者3.2%(3/95)],差异有统计学意义(P0.01)。TCT检查为低度鳞状上皮内病变(low grade squamous intraepithelial lesion,LSIL)16例,其中HR-HPV阳性者宫颈活检阳性率为58.3%(7/12),高于HR-HPV阴性者50.0%(2/4)],差异无统计学意义(P0.05)。TCT检查为高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)24例,其中HR-HPV阳性率为95.8%(23/24),宫颈活检阳性率为100%(24/24)。结论:HR-HPV检测对TCT检查结果为ASCUS的筛查有重要临床意义。

Value of Detection of High-Risk Human Papillomavirus in Screening for Cervical Intraepithelial Neoplasia

Objective：To assess the value of detection of high-risk human papillomavirus（HR-HPV） in screening for cervical intraepithelial neopIasia and cervical cancer. Methods： In outpatient clinic of Department of Gynecology, Putuo District People＇s Hospital of Shanghai,a total of 195 cases whose thinprep cytologic test（TCT） results were positive were checked by HR HPV test and multiple cervical biopsy from Jan 2010 to Oct 2012. Results： TCT results were atypical squamous cells of undetermined significance（ASCUS） in 155 cases. Positive rate of cervical biopsy was 30.0% （18/60） in cases with HR-FIPV positive, much higher than that in cases with HR-HPV negative3.2% （3/95）]. The difference was statistically significant（P〈0.01 ）. TCT results were low grade squamous intraepithelial lesion（LSIL） in 16 cases. Positive rate of cervical biopsy was 58.3% （7/12） in cases with HR-HPV positive, higher than that in cases with HR-HPV negative50.0%（2/4）]. The difference was not statisti- cally significant（P〉0.05）. TCT results were high grade squamous intraepithelia lesion（HSIL） in 24 cases, in whom the posi- tive rate of HR-HPV was 95.8% （23/24）,and the positive rate of cervical biopsy was 100% （24/24）. Conclusions： Detection of HR-HPV has important guiding significance in screening for ASCUS of TCT results.