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目的探讨高危型HPV检测在ASCUS分流管理中的作用及意义。方法对165例宫颈细胞学诊断为AS-CUS的患者,联合采用检测高危型HPV和阴道镜下定位多点活检的组织病理学检查,分析比较ASCUS高危型HPV阳性患者与高危型HPV阴性患者的宫颈病变的发病情况。结果①早期宫颈癌4例,占2.42%;CINⅠ37例,占22.4%,CINⅡ29例,占17.6%;CINⅢ9例,占5.45%;宫颈炎症86例,占52.1%。②本组患者高危型HPV感染阳性率57.6%(95/165),HPV感染排序为HPV16、52、58、18、CP8304。③高危型HPV阳性组病理结果为CINⅡ级或以上病变检出率为37.9%(36/95),明显高于高危型HPV阴性组8.57%(6/70,P<0.01);4例早期宫颈癌高危HPV均是阳性,其中HPV16阳性2例,HPV58阳性和HPV18阳性各1例。结论宫颈上皮内瘤变及高级别CIN的发生与高危型HPV感染密切相关,HPV高危型以HPV16、52型为最常见类型。液基细胞学检查ASCUS辅以高危型HPV检测可以有效分流管理AS-CUS患者。
Objective To explore the role and significance of high-risk HPV testing in ASCUS shunt management. Methods Totally 165 patients with cervical cytology diagnosed as AS-CUS were enrolled in this study. Histopathological examination of high-risk HPV and colposcopic multipoint biopsy was performed to analyze the association between ASCUS high-risk HPV positive patients and high-risk HPV negative patients The incidence of cervical lesions. Results ① Early cervical cancer in 4 cases, accounting for 2.42%; CINⅠ37 cases, accounting for 22.4%, CINⅡ29 cases, accounting for 17.6%; CINⅢ9 cases, accounting for 5.45%; Cervical inflammation in 86 cases, accounting for 52.1%. ② The positive rate of high-risk HPV infection in this group was 57.6% (95/165). HPV infection ranked HPV16,52,58,18 and CP8304. (3) The positive rate of high-risk HPV-positive group was 37.9% (36/95), which was significantly higher than that of high-risk type HPV negative group (8.57%, 6/70, P <0.01) High-risk HPV were positive, including HPV16-positive in 2 cases, HPV58-positive and HPV18-positive in 1 case. Conclusions Cervical intraepithelial neoplasia and high-grade CIN are closely related to high-risk HPV infection. The high-risk HPV types HPV16 and 52 are the most common types. Liquid-based cytology ASCUS supplemented with high-risk HPV testing can effectively bypass AS-CUS patients.