HPV检测在“不典型鳞状细胞-不除外宫颈高度上皮内病变”中的意义

基础医学与临床 ›› 2011, Vol. 31 ›› Issue (7): 827-830.

HPV检测在“不典型鳞状细胞-不除外宫颈高度上皮内病变”中的意义

张小燕¹,卞美璐²,陈庆云²

1. 北京市海淀区妇幼保健院
2. 中日友好医院

收稿日期:2010-09-16 修回日期:2010-12-29 出版日期:2011-07-05 发布日期:2011-07-05
通讯作者: 卞美璐 E-mail:bianmeilu@hotmail.com

Clinical Significance of the Triage Role of HR-HPV for Atypical Squamous Cells, cannot Exclude High-grade Squamous Intraepithelial Lesion

Xiao-yan ZHANG¹,Mei-lu BIAN²,Qing-yun CHEN³

1. Haidian Maternal and Children Healthcare Hospital
2. China-Japan Friendship Hospital
3.

Received:2010-09-16 Revised:2010-12-29 Online:2011-07-05 Published:2011-07-05
Contact: Mei-lu BIAN E-mail:bianmeilu@hotmail.com

摘要/Abstract

摘要： 目的探讨高危型人乳头状瘤病毒（HR – HPV ）检测对细胞病理学诊断为不典型鳞状细胞-不除外宫颈高度上皮内病变的 (ASC-H)患者的临床处理价值。方法 2004年6月～2007年4月于中日友好医院妇产科门诊进行宫颈细胞学检查的患者17 125例，选择其中细胞学诊断结果为不典型鳞状细胞的患者，应用第二代杂交捕获方法检测HR-HPV,观察HR-HPV检测对细胞学诊断结果为ASC-H进行分流的意义。结果 HR-HPV阳性的 ASC-H患者中宫颈高度病变的检出率（48.1%）显著高于ASC-US （25.2%），（P <0.01）。13例HR-HPV阴性的ASC-H患者中1例宫颈活组织检查结果为CIN2（Cervical Intraepithelial Neoplasia,CIN）(5.9%),与ASC-US（5.7%）相比无差异。在ASC- US和ASC-H患者中，HR-HPV检测对于宫颈高度病变的敏感性分别为82.8%、96.2% ，阴性预告值分别为94.3%，92.3%。结论对于HR-HPV阴性的ASC-H患者可以考虑定期随诊细胞学和高危型HPV，减少阴道镜检查，HR-HPV检测可能对于ASC-H患者同样具有分流作用。

关键词: 人乳头状瘤病毒, 细胞学, 阴道镜

Abstract: Objective To evaluate the possible role of HR-HPV testing for ASC-H in clinical practice.Methods Among 17 125 cervical smesrs in China-Japan friendship hospital from June 2004 to April 2007 ,those interpreted as ASC and those had HR-HPV testing were enrolled in the study.The possible role of triage of HR-HPV testing for ASC-H was evaluated according to the results of biopsy.Results CIN 2/3 was identified in 25 of 52(48.1%) patients with HR-HPV positive ASC-H compared with 48 of 190 (25.2%)patients with HR-HPV positive ASC-US（P <0.01）. CIN 2/3 was identified on a follow-up in a similarly small proportion of both patients with HR-HPV negative ASC-H and patients with HR-HPV negative ASC-US (5.9%、5.7%，respectively).The sensitivity of HR-HPV testing in detecting CIN 2/3 for ASC-US and ASC-H was 82.8%,96.2% ,respectively;and the negative prective rate was 94.3%,92.3% ,respectively. Conclusions Patients with ASC-H and negative HR- HPV testing may be more efficiently managed by follow-up with regular Pap and HR-HPV testing rather than universal colposcopy.HR-HPV testing for triage of ASC-H in routine practice may have the same important triage role as for ASC-US.

Key words: HPV, cytology, colposcopy

中图分类号:

张小燕卞美璐陈庆云. HPV检测在“不典型鳞状细胞-不除外宫颈高度上皮内病变”中的意义 [J]. 基础医学与临床, 2011, 31(7): 827-830.

Xiao-yan ZHANG Mei-lu BIAN Qing-yun CHEN. Clinical Significance of the Triage Role of HR-HPV for Atypical Squamous Cells, cannot Exclude High-grade Squamous Intraepithelial Lesion[J]. Basic & Clinical Medicine, 2011, 31(7): 827-830.