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目的通过与液基细胞学和病理组织学检查结果比较,评价高危型人乳头瘤病毒(HR-HPV)检测在子宫颈癌癌前病变筛查中的应用价值。方法对2007年8月—2009年8月在安阳市肿瘤医院妇科行HR-HPV、液基细胞学检查及电子阴道镜下宫颈活组织病理检查的390例患者的资料进行回顾性分析。结果 390例患者中,HR-HPV在不同级别细胞学中阳性率分别为53.67%(95/177)、71.28%(72/101)、81.36%(48/59)和100%(12/12)。细胞学级别越高,HR-HPV阳性率也增高;病理组织学诊断为宫颈急慢性炎症、CIN1、CIN2/CIN3和宫颈浸润癌者分别为231、47、91和21例,HR-HPV阳性率分别为41.9%(97/231)、76.59%(36/47)、90.11%(82/91)和95.24%(20/21)。HR-HPV阳性率在病理结果为炎症者中为41.27%(97/235),CIN1中为76.59%(36/47),CIN2/CIN3中为90.11%(82/91),宫颈浸润癌中为95.23%(20/21),HR-HPV的阳性率随着病理学级别增高也增高。在177例ASC中,HR-HPV阳性95例中,病理学≥CIN1占46.31%(44/95),其中CIN2/CIN3和宫颈浸润癌占70.45%(31/44)。结论 HR-HPV检测已成为子宫颈癌癌前病变的一种防癌筛查手段,与液基细胞学检查结合有利于子宫颈癌癌前病变的处理,可提高宫颈癌及癌前病变的检出率。
Objective To evaluate the value of high-risk human papillomavirus (HR-HPV) detection in the screening of precancerous lesions of cervical cancer by comparing with liquid-based cytology and histopathological examination. Methods The data of 390 patients who underwent gynecological HR-HPV, liquid-based cytology and cervical biopsy under electronic colposcopy in Anyang Tumor Hospital from August 2007 to August 2009 were analyzed retrospectively. Results Among 390 patients, the positive rates of HR-HPV in different grades of cytology were 53.67% (95/177), 71.28% (72/101), 81.36% (48/59) and 100% (12/12), respectively . The higher the level of cytology, HR-HPV positive rate also increased; pathological diagnosis of acute and chronic cervical inflammation, CIN1, CIN2 / CIN3 and invasive cervical cancer were 231,47,91 and 21 cases, HR-HPV positive rate 41.9% (97/231), 76.59% (36/47), 90.11% (82/91) and 95.24% (20/21), respectively. The positive rate of HR-HPV was 41.27% (97/235) in pathological results of inflammation, 76.59% (36/47) in CIN1, 90.11% (82/91) in CIN2 / CIN3, 95.23% (20/21). The positive rate of HR-HPV increased with the pathological grade. Of the 177 cases with ASC-positive HR-HPV, 95.3% of the 95 cases were pathologically diagnosed as CIN1, accounting for 46.31% (44/95) of them with CIN2 / CIN3 and 70.45% (31/44) of invasive cervical cancer. Conclusion HR-HPV test has become an anti-cancer screening tool for cervical precancerous lesions. Combined with liquid-based cytological examination, it is beneficial to the treatment of precancerous lesions of cervical cancer and can improve the detection of cervical cancer and precancerous lesions Rate out.