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目的:探讨HR-HPV检测和阴道镜检查在不典型鳞状细胞(ASCUS)进一步处理措施中的分流作用。方法:对宫颈液基细胞学诊断为ASCUS的385例患者,分别进行HPV检测、阴道镜评估及镜下活组织检查。结果:385例ASCUS患者,组织学诊断为CIN 125例,发生率32.47%(125/385),其中高级别CIN(≥CINⅡ)及宫颈癌35例,占9.09%(35/385)。HR-HPV阳性215例,阳性率55.84%(215/385),HR-HPV阳性组CIN检出率为46.98%(101/215),HR-HPV阴性组CIN检出率为14.21%(24/170),两组比较差异有统计学意义,χ2=46.75,P<0.01。阴道镜拟诊≥CINⅡ28例,符合24例,符合率85.71%。HR-HPV检测对发现ASCUS中≥CINⅡ病变的敏感性和阴性预测值分别为91.43%(32/35)和98.24%(167/170),阴道镜检查则分别为68.57%(24/35)和96.92%(346/357)。结论:ASCUS中存在高比例的CIN,包括高级别病变和浸润癌。HR-HPV检测是一项敏感的分流手段,可有效浓缩ASCUS中潜在的CIN患者。
Objective: To investigate the shunt effect of HR-HPV test and colposcopy in further treatment of atypical squamous cells (ASCUS). Methods: 385 patients diagnosed as cervical lymphocytic cytology by ASCUS were examined with HPV, colposcopy and microscopic biopsy respectively. Results: A total of 385 ASCUS patients were diagnosed as CIN with a histological diagnosis of 125 cases (125/385). The high grade CIN (≥CIN Ⅱ) and cervical cancer (35 cases) accounted for 9.09% (35/385). HR-HPV positive 215 cases, the positive rate of 55.84% (215/385), HR-HPV positive group CIN detection rate was 46.98% (101/215), HR-HPV negative group CIN detection rate was 14.21% (24 / 170), the difference between the two groups was statistically significant, χ2 = 46.75, P <0.01. Colposcopic diagnosis ≥ CIN Ⅱ 28 cases, in line with 24 cases, in line with the rate of 85.71%. The sensitivity and negative predictive value of HR-HPV testing for detecting ≥CINII lesions in ASCUS were 91.43% (32/35) and 98.24% (167/170), respectively, and 68.57% (24/35) in colposcopy and 96.92% (346/357). Conclusion: There is a high proportion of CIN in ASCUS, including high grade lesions and invasive carcinoma. The HR-HPV test is a sensitive diverter that effectively concentrates potential CIN patients in ASCUS.