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目的明确高危型人乳头瘤病毒基因(highriskhumanpapillomavirusDNA,HRHPVDNA)检测在宫颈不典型鳞状细胞(atypicalsquamouscell,ASC)再分类中的意义,为其临床应用提供依据。方法我院2002年于山西省阳城县和襄垣县进行的“中国山西宫颈癌普查方法研究”项目中,9034名妇女均进行了液基细胞学检查、HRHPVDNA检测和5%醋酸染色肉眼观察。我们对其中细胞学诊断为ASC,伴有HRHPVDNA检测阳性或5%醋酸染色肉眼观察异常的病例进行了阴道镜检查及活检,比较HRHPVDNA阳性ASC组和HRHPVDNA阴性5%醋酸染色肉眼观察阳性ASC组中宫颈上皮内瘤变(Cervicalintraepithelialneoplasia,CIN)的发生率,从而评价HRHPVDNA检测作为ASC再分类方法的可行性。结果在进行阴道镜检查的548例ASC中,HRHPVDNA阳性者有333例(60.8%),HRHPVDNA阴性肉眼观察阳性者215例(39.2%)。这两组ASC中CIN的发生率分别为22.5%和5.1%(P<0.05);CIN2/3的发生率分别为7.8%和0.9%(P<0.05)。结论HRHPVDNA检测是ASC再分类的有效方法。
Objective To determine the significance of highrisk human papillomavirus DNA (HRHPVDNA) detection in the reclassification of atypical squamous cell carcinoma (ASC) and provide the basis for its clinical application. Methods A total of 9034 women underwent liquid-based cytology, HRHPVDNA and 5% acetic acid staining in the project of “China’s Cervical Cancer Screening in Shanxi Province, China” conducted in Yangcheng County and Xiangyuan County in Shanxi Province in 2002. Colposcopy and biopsy were performed on cases in which cytology was diagnosed as ASC, HRHPVDNA was positive, or 5% acetic acid staining was unaffected by naked eyes. HRHPVDNA positive ASC group and HRHPVDNA negative 5% acetic acid staining were observed in the positive ASC group Cervical intraepithelial neoplasia (Cervical intraepithelial neoplasia, CIN) incidence, thereby evaluating HRHPVDNA detection as an ASC reclassification method feasibility. Results Among the 548 ASC patients who underwent colposcopy, 333 (60.8%) were HRHPVDNA positive and 215 (39.2%) were HRHPVDNA negative. The incidence of CIN in both groups was 22.5% and 5.1%, respectively (P <0.05). The incidence of CIN2 / 3 was 7.8% and 0.9%, respectively (P <0.05). Conclusion HRHPVDNA detection is an effective method of ASC re-classification.