目的:探讨人乳头瘤病毒(HPV)L1壳蛋白筛查HPV阳性妇女宫颈脱落细胞中宫颈鳞状上皮内病变的应用价值。方法:选取2012年5月至2014年12月就诊于温州市人民医院的妇女212例,收集宫颈脱落细胞并行HPV L1壳蛋白检测、HPV DNA分型、TCT(液基细胞学)及阴道镜下活检,比较HPV阳性妇女的宫颈脱落细胞中HPV L1壳蛋白的表达情况。结果:212例细胞学标本中HPV L1壳蛋白阳性率为33.9%,其中未见上皮内病变/恶性细胞组(NILM)、无明确诊断意义的鳞状上皮细胞病变组(ASCUS)、低度鳞状上皮内病变组(LSIL)、不能排除高度鳞状上皮内病变组(ASC-H)、高度鳞状上皮内病变组(HSIL)中阳性率分别为47.1%、35.1%、54.2%、29.2%、16.1%,各组比较差异有统计学意义(P<0.05);两两比较,HSIL组与LSIL组和NILM组比较,差异均有统计学意义(P均<0.005);进行数据合并后,LSIL/ASCUS组与ASC-H/HSIL组比较差异有统计学意义(P=0.001)。178例宫颈细胞学异常患者中,宫颈低级别病变和宫颈高级别病变的HPV L1壳蛋白阳性率比较,在ASCUS组(P=0.000)、LSIL组(P=0.004)中均有差异,在ASC-H组(P=0.127)、HSIL组(P=0.515)中均无差异。HPV 16/18感染患者的HPV L1壳缺失同宫颈高级别病变有更紧密的关系(P=0.003)。结论:子宫颈脱落细胞HPV L1壳蛋白检测在HPV阳性妇女的子宫颈病变筛查中具有一定的价值,可能成为一种合适的分流方法。 Objective: To investigate the value of HPV L1 capsid protein screening for cervical squamous intraepithelial lesion in cervical exfoliated cells of HPV-positive women. Methods: A total of 212 women who visited Wenzhou People ’s Hospital from May 2012 to December 2014 were enrolled in this study. HPV L1 capsid protein, HPV DNA typing, TCT (liquid based cytology) and colposcopy were collected. Biopsy was performed to compare HPV L1 capsid protein expression in exfoliated cells of HPV-positive women. Results: The positive rate of HPV L1 capsid protein in 212 cases of cytological specimens was 33.9%. There were no intraepithelial lesion / malignant cell group (NILM), no clear diagnosis of squamous cell disease group (ASCUS), low grade The positive rates of LSIL, ASC-H and HSIL were 47.1%, 35.1%, 54.2%, 29.2% respectively in the group of LSIL, , 16.1% respectively, there was significant difference between each group (P <0.05). After pairwise comparisons, the difference between HSIL group and LSIL group and NILM group was statistically significant (P <0.005) The difference between LSIL / ASCUS group and ASC-H / HSIL group was statistically significant (P = 0.001). 178 cases of cervical cytology abnormalities, cervical low-grade lesions and high-grade cervical lesions of HPV L1 capsid protein positive rate in the ASCUS group (P = 0.000), LSIL group (P = 0.004) were different in the ASC -H group (P = 0.127), HSIL group (P = 0.515). HPV L1 capsular deletion in patients with HPV 16/18 infection has a closer relationship with high-grade cervical lesions (P = 0.003). Conclusion: The detection of HPV L1 capsid protein in cervical exfoliated cells has some value in the screening of cervical lesions in HPV-positive women and may be a suitable shunt method.