高危型HPV-DNA检测在宫颈细胞学ASCUS分流管理中的应用

目的探讨高危型HPV-DNA检测在宫颈细胞学ASCUS分流管理中的临床应用价值。方法 2010年6月～2012年6月在我院妇科门诊行宫颈液基细胞学检查(TCT)结果为ASCUS的194例患者进行高危型人乳头瘤病毒检测,同时行阴道鏡检查及宫颈活组织检查或宫颈管内膜刮除术。HPV-DNA检测阴性者予阴道抗炎治疗3个疗程后复查TCT。HPV-DNA检测阳性,病理为高级别上皮类瘤变行宫颈LEEP刀锥切进一步诊断及治疗,病理为低级别上皮内瘤变者可4～6月定期检查或局部治疗(微波)。结果 194例宫颈细胞学ASCUS患者中HPV-DNA阳性者46例,共检出宫颈上皮类瘤变22例。HPV-DNA阴性者148例,共检出宫颈上皮类瘤变6例。结论 HPV-DNA检测可有效检出宫颈细胞学ASCUS中CIN患者,可作为对宫颈细胞学ASCUS进行有效分流管理的方法。

Detection of high risk HPV-DNA in cervix cytology ASCUS diffiuent management

Objective To investigate the clinical application value of the detection of high risk HPV-DNA in cervix cytology ASCUS diffluent management.Methods 194 patients in our gynecology department from June 2010 to June 2012 whose thinprep cytologic test（TCT） showed result of ASCUS were given detection of high risk HPV-DNA.At the same time,all the 194 cases underwent colposcopy and cervical biopsy or curettement of cervical canal endomembrane.Those whose TCT was negative were given vagina anti-inflammatory treatment for three months and rechecked afterwards.Those who had positive HPV-DNA and were pathologically identified as grade Ⅲ cervical intraepithelial neoplasia（CINⅢ） received further LEEP knife diagnose and treatment.Those who had grade CINI-II would take regular inspection for 4 ～ 6 months or take microwave treatment.Results Of all the 194 patients with TCT ASCUS,22 CIN examples were detected in 46 HPV-DNA positive cases.Six CIN examples were checked out in 148 patients with HPV-DNA negative.Conclusion HPV-DNA detection can effectively detect CIN in ASCUS patients.It should be a good method for diffluent management in cervix cytology ASCUS patients.