高危型HPV-DNA检测在宫颈病变ASCUS中诊断价值的探讨

目的探讨宫颈液基细胞学（Thinprep cytologytest，TCT）结果为不明确意义的不典型鳞状上皮细胞（Atypical Squamous Cell of Undetermined Significance，ASCUS）的病例中高危型人乳头状瘤病毒（HPV）负荷量与宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）病变程度的相关性，说明HPV—DNA检测在ASCUS诊断中的分流作用。方法对2009年1月-2012年11月就诊于我院妇科门诊并经TCT筛查结果为ASCUS，且病理组织学结果为CIN的332例患者，采用杂交捕获二代（HC-2）技术对患者进行HPV-DNA病毒负荷量的检测。检测结果根据病毒负荷量分为低病毒负荷量组（1.00-10．00）、中病毒负荷量组（10.00-100．00）和高病毒负荷量组（≥100），分析HPV—DNA病毒负荷量与CIN病变程度的相关性。结果332例病理组织学结果为CIN的ASCUS患者中，HPV负荷量呈阳性（〉1．00）患者296例，其中低病毒负荷量组29例，占980％，中病毒负荷量组58例，占19．59％，高病毒负荷量组209例，占70．61％。低病毒负荷量患者中，中、高程度CIN（HSIL）的患者总计16例，发生率为5517％；中病毒负荷量患者中有2例鳞癌患者，病理组织学结果为CIN的患者中，中高程度CIN的患者总计34例，发生率为6071％；高病毒负荷量患者中有4例鳞癌患者，病理组织学结果为CIN的患者中，中高程度CIN的患者总计156例，发生率为7610％，分布差异显著（P〈0．05）。结论在ASCUS病例中，CIN病变程度与HPV-DNA病毒负荷量呈正相关，即HPV-DNA病毒负荷量越高，CIN痛变程度越高。

The diagnostic value of high-risk HPV testing in atypical squamous cells undetermined Significance

Objective This research aims to explore the correlation between the loads of HPV in patients who suffer from ASCUS and the diseased level of cervical intraepitheiial neoplasia. Based on the result of the research, the author means to show that the testing of HPV-DNA could effectively shunt the ASCUS patients. Methods All the patients who are diagnosed as atypical squamous ceil of undetermined significance by taking TCT in the Central Hospital of Taian from January 2009 to November 2012. What＇s more, all cases are diagnosed as some kinds of level of CIN, and all of which test the load capacity of HPV using the hybrid capture II technology. Patients are divided into three groups： the first group is the low HPV load group, in which patients who have HPV load between 1 and 10~ the second group is the middle HPV load group, and patients in this group are having HPV load between 10 and 100. The third group is the high HPV load group, which contains all patients whose HPV load is more than 100. Results In 332 cases who are diagnosed as ASCUS and suffer from any degree of CIN, the percent of patients who have senior CIN in low HPV load group, middle HPV load group and high HPV load group is 55.17%, 60.71%, 76.10%, respectively. Conclusion There is a positive correlation between the degree of CIN and the HPV load in patients who have ASCUS.