高危型人乳头瘤病毒检测在宫颈环形电切治疗中的意义

目的:研究高危型人乳头瘤病毒(HR-HPV)对非典型鳞状细胞(ASC)或低度鳞状上皮内病变(LSIL)患者进行宫颈环形电切(LEEP)治疗的辅助诊断价值。方法:回顾性分析186例ASC或LSIL患者的HR-HPV检测、阴道镜下活检病理和LEEP病理结果,比较HR-HPV阳性和阴性患者中高级别病变(CIN2+)的发生率。结果:ASCUS、ASC-H和SLIL患者中HR-HPV的阳性率分别为67.1%、75.0%和89.3%,活检病理结果为CIN2+的比例分别为13.4%、60.0%和32.1%,而LEEP病理结果为CIN2+的比例分别为19.5%4、5.0%和33.3%。最终病理结果为CIN2+的患者在HR-HPV阳性患者中的比例为37.9%,而在HR-HPV阴性患者中的比例为17.0%,差异具有显著性(χ2=5.873,P=0.015)。结论:细胞学结果为低级别病变的患者中存在较高比例的高级别病变患者,检测HR-HPV有助于及时发现高级别病变患者。

Significance of detecting high risk human papillomavirus before loop electrosurgical excisional procedure

Objective:To investigate the significance of detecting high risk human papillomavirus(HR-HPV) in patients with atypical squamous cells(ASC) or low-grade squamous intraepithelial lesion(LSIL) before loop electrosurgical excisional procedure(LEEP) treatment.Methods: A total of 186 patients with ASCUS,ASC-H,or LSIL were retrospectively analyzed.Results of HR-HPV detection,biopsy and LEEP biopsy were reviewed.The occurrence rates of cervical intraepithelial neoplasia 2 or worse(CIN2+) were compared between HR-HPV positive and negative patients.Results: The positive rates of HR-HPV in patients with ASCUS,ASC-H and LSIL were 67.1%,75% and 89.3%,respectively.The occurrence rates of CIN2+ were 13.4%,60% and 32.1% by biopsy,respectively,and 19.5%,45.0% and 33.3% by LEEP pathology,respectively.The final pathology results of CIN2+ were found in 37.9% of the patients with HR-HPV infection,significantly higher than that in HR-HPV negative patients(17.0%,χ2=5.873,P=0.015).Conclusion: High grade cervical intraepithelial neoplasia was found in many patients with low grade lesions tested by cytological test.Detection of HR-HPV may be useful to find high grade neoplasia early and timely.