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目的:探讨宫颈细胞检查为不典型鳞状上皮细胞在宫颈病变中的临床意义,为临床提供指导和管理依据。方法:对402例细胞学检查为ASC的患者行阴道镜检查及定位活检,其中202例患者同时进行了高危HPV-DNA检测。结果:20～39岁患者高级别CIN(CINⅡ～CINⅢ)的发生率明显高于其他年龄组(P<0.05)。ASC包含各级别宫颈病变,CIN的发生率为40.02%,高级别CIN(CINⅡ～CINⅢ)及浸润癌的发生率为9.70%,阴道镜诊断与病理学结果有较高一致性,Kappa=0.7(P<0.001)。高危型HPV-DNA阳性组CIN检出率为78.38%,明显高于阴性组的17.19%(P<0.05),高级别CIN(CINⅡ～CINⅢ)27例中26例HPV-DNA检测为阳性,鳞癌1例,HPV-DNA检测为阳性。结论:ASC中有较高的宫颈病变发生率,阴道镜检查对宫颈病变诊断有较高的预测价值,可以指导ASC的分流管理。高危HPV-DNA检测是有效的辅助诊断技术。
Objective: To investigate the clinical significance of cervical cell examination in atypical squamous cell in cervical lesions, and provide guidance and management basis for clinical practice. Methods: Collective colposcopy and biopsy were performed on 402 patients with ASC cytology. Of 202 patients, high-risk HPV-DNA was detected simultaneously. Results: The incidence of high grade CIN (CINⅡ-CINⅢ) in patients aged 20-39 was significantly higher than that in other age groups (P <0.05). The incidence of CIN was 40.02%. The incidence of CIN (CINⅡ-CINⅢ) and invasive carcinoma was 9.70%. Colposcopic diagnosis was consistent with pathological findings. Kappa = 0.7 P <0.001). High-risk HPV-DNA positive group CIN detection rate was 78.38%, significantly higher than the negative group 17.19% (P <0.05), high-grade CIN (CIN Ⅱ CIN Ⅲ) 27 cases of HPV-DNA in 26 cases were positive, 1 case of cancer, HPV-DNA test was positive. Conclusion: ASC has a higher incidence of cervical lesions, colposcopy on the diagnosis of cervical lesions have a higher predictive value, can guide the diversion of ASC management. High-risk HPV-DNA testing is an effective adjunctive diagnostic technique.