论文部分内容阅读
目的:探讨在ASC-H患者中检测HR-HPV DNA预测宫颈上皮内瘤样病变(CIN)和浸润癌的价值,为完善CIN和浸润癌的筛查方案提供依据。方法:研究宫颈薄层液基细胞学诊断为ASC-H的患者68例,均进行HR-HPV DNA检测并在阴道镜下行宫颈组织活检,综合评价HR-HPV预测高级别CIN的价值。结果:在ASC-H中CIN发生率为52.9%(36/68),CINⅡ及以上病变(CINⅡ、CINⅢ及浸润癌)发生率为33.8%(23/68);HR-HPV检测阳性率为70.6%(48/68),HR-HPV阳性组CINⅡ及以上病变发生率为47.9%(23/48),HR-HPV阴性组CINⅡ及以上病变发生率为0(0/20),两组比较差异有统计学意义,χ2=14.797,P=0.001,HR-HPV诊断CINⅡ及以上病变的敏感度和特异度分别为100.0%和44.4%,阳性预测价值和阴性预测价值分别为47.9%和100.0%。结论:初步研究结果提示,HR-HPV阳性ASC-H患者应高度警惕CINⅡ及以上病变发生,建议立即行阴道镜检查;而HR-HPV阴性患者可不进行阴道镜检查。
Objective: To investigate the value of HR-HPV DNA in predicting cervical intraepithelial neoplasia (CIN) and invasive carcinoma in patients with ASC-H, so as to provide evidences for screening programs of CIN and invasive carcinoma. Methods: Sixty-eight patients diagnosed as ASC-H by cervical smear-based cytology were examined by HR-HPV DNA and cervical biopsy under colposcopy. The value of HR-HPV in predicting high-grade CIN was evaluated. Results: The incidence of CIN in ASC-H was 52.9% (36/68), and the incidence of CINⅡ and above lesions (CINⅡ, CINⅢ and invasive carcinoma) was 33.8% (23/68). The positive rate of HR-HPV was 70.6 % (48/68). The incidence of CINⅡ and above lesions in HR-HPV positive group was 47.9% (23/48), and the incidence of CINⅡ and above lesions in HR-HPV negative group was 0 (0/20) The sensitivity and specificity of HR-HPV in diagnosing CINⅡ and above lesions were 100.0% and 44.4%, respectively. The positive predictive value and negative predictive value were 47.9% and 100.0% respectively. Χ2 = 14.797, P = 0.001. Conclusion: The preliminary results suggest that HR-HPV positive ASC-H patients should be highly vigilant for the occurrence of CINⅡ and above, and colposcopy should be recommended immediately. However, colposcopy should not be performed in patients with negative HR-HPV.