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目的:评价高危型HPV DNA检测在ASC-US分流中的作用,探讨液基细胞学检查为ASC-US患者的最佳管理方案。方法:选取2007年1月至2009年12月在唐山市妇幼保健院行液基细胞学检查报告为ASC-US、具有完整随访记录的800例病例进行回顾性分析,其中400例进行高危型HPV DNA检测,阳性者行阴道镜下多点活检,阴性者定期随访;400例进行重复细胞学检查,6个月后复查液基细胞学,报告ASC-US及以上病变者行阴道镜下多点活检,阴性者12个月后再次复查液基细胞学。比较两种方法的病变检出率。结果:高危型HPV DNA检测阳性254例,其中162例经活检证实存在CIN病变,单次检测病变检出率为40.5%。定期细胞学复查者中,174例再次报告ASC-US,其中118例经活检证实存在CIN;23例在12个月后的第二次复查中再次报告ASC-US,其中14例经活检证实存在CIN。重复细胞学检查组的病变检出率(33.0%)显著低于高危型HPV DNA检测组(P<0.05)。结论:高危型HPV DNA检测在对ASC-US患者的管理中能够迅速有效地发现病变,较重复细胞学检查有明显的优势。
OBJECTIVE: To evaluate the role of high-risk HPV DNA testing in ASC-US shunt and to explore the best management strategy for ASC-US patients with liquid-based cytology. Methods: A retrospective analysis of 800 cases with complete follow-up records from January 2007 to December 2009 in Tangshan Maternal and Child Health Care Hospital was conducted. ASC-US was performed on 400 cases of high-risk HPV DNA test, positive colposcopy multipoint biopsy, negative regular follow-up; 400 cases of repeat cytology, review of liquid-based cytology after 6 months, report ASC-US and above lesions under colposcopy multipoint Biopsy, negative again 12 months after liquid-based cytology review. Compare the detection rate of the two methods. Results: High-risk HPV DNA tests were positive in 254 cases, of which 162 cases of CIN lesions confirmed by biopsy, single detection of lesions was 40.5%. Of the regular cytological evaluations, 174 reported ASC-US again, 118 of whom were confirmed by biopsy for CIN; 23 reported ASC-US again during the second review 12 months later, of which 14 were confirmed by biopsy CIN. The detection rate of lesions in repeat cytology group (33.0%) was significantly lower than that in high-risk HPV DNA test group (P <0.05). CONCLUSIONS: High-risk HPV DNA testing can detect lesions quickly and effectively in the management of ASC-US patients, with clear advantages over repeat cytology.