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目的:探讨高危型人乳头瘤病毒(HPV)检测对无明确诊断意义的不典型鳞状上皮细胞(ASC-US)分流监测的临床价值。方法:应用第二代杂交捕获实验(HC-Ⅱ)对261例宫颈细胞学检查结果为ASC-US的患者进行高危型HPVDNA检测,以光镜下病理学诊断作为宫颈上皮内瘤样病变(CIN)的分级标准。结果:261例ASC-US患者CIN检出率为60.92%(159/261),其中高级别CIN16例,检出率为6.13%。261例ASC-US患者高危型HPV DNA检测呈阳性者141例,阳性率为54.02%,高级别CIN中HPV DNA阳性率高达93.75%,高危型HPV阳性组和阴性组ASC-US患者宫颈病变为CINⅡ及其以上病变的检出率分别为11.35%和0.83%,差异具有统计学意义(P<0.01)。结论;ASC-US患者中包括部分高级别病变甚至宫颈癌,并存在相当比例的HPV感染,高危型HPV-DNA检测是一种有效的ASC-US分流管理手段。
Objective: To investigate the clinical value of high-risk human papillomavirus (HPV) detection in the diagnosis of atypical squamous cell (ASC-US) without clear diagnosis. Methods: High-risk HPV DNA was detected in 261 patients with cervical cytology ASC-US using second-generation hybridization capture assay (HC-Ⅱ). The pathological diagnosis of cervical intraepithelial neoplasia (CIN ) Of the grading standards. Results: The detection rate of CIN in 261 ASC-US patients was 60.92% (159/261), of which 16 cases were high grade CIN with the detection rate of 6.13%. Among 261 ASC-US patients, 141 cases were positive for high-risk HPV DNA test, the positive rate was 54.02%. The positive rate of HPV DNA in high-grade CIN was 93.75%. The cervical lesions in high-risk HPV positive group and negative group ASC-US patients were The detection rates of CINⅡ and above lesions were 11.35% and 0.83%, respectively, with statistical significance (P <0.01). Conclusion: ASC-US patients, including some high-grade lesions and even cervical cancer, and there is a considerable proportion of HPV infection, high-risk HPV-DNA test is an effective ASC-US shunt management.