论文部分内容阅读
目的探讨宫颈低级别鳞状上皮内病变不除外高级别鳞状上皮内病变(low-grade squamous intraepitheliallesion,cannot exclude high-grade squamous intraepithelial lesion,LSIL-H)作为宫颈液基细胞学独立诊断标准对临床宫颈病变诊疗及风险估计的指导意义。方法收集近6年来130 000例液基细胞学标本,采用双盲法进行回顾性诊断分析,并追踪高危型人乳头瘤病毒(high risk-HPV,HR-HPV)的感染情况和组织病理学结果。结果选择LSIL 1 250例(0.96%),LSIL-H 382例(0.29%),非典型鳞状上皮细胞,不除外高度鳞状上皮内病变(atypical squamous cells,cannot ruleout a high grade lesion,ASC-H)296例(0.23%),高度鳞状上皮内病变(high squamous intraepithelial lesion,HSIL)497例(0.38%)列入本次研究的对象,结合组织病理学结果及高危型人乳头瘤病毒感染的结果分析显示,在宫颈高级别鳞状上皮内病变CIN2/3的患病率中,LSIL-H(45%)高于LSIL(10%),而低于HSIL(66%),差异具有统计学意义(P<0.01),而与ASC-H(43%)相比较差异无统计学意义(P>0.05);其中宫颈低级别鳞状上皮内病变CIN1的患病率中,LSIL-H(36%)高于ASC-H(12%),差异具有统计学意义(P<0.01);LSIL-H的HR-HPV阳性率(79%)高于LSIL(47%)和ASC-H(60%),并低于HSIL(91%),差异均具有统计学意义(P<0.01)。结论 LSIL-H具有较高的患高级别鳞状上皮内病变(CIN2/3)的风险率和HR-HPV感染率,LSIL-H的独立诊断对加强宫颈上皮内瘤样病变的筛查、管理,以及对临床宫颈病变的分流指导及风险的估计具有较高的价值。
Objective To investigate the clinical value of low-grade squamous intraepithelial lesion (can not exclude high-grade squamous intraepithelial lesion, LSIL-H) as an independent diagnostic criteria of cervical liquid-based cytology Guiding Significance of Diagnosis and Treatment of Cervical Lesions and Risk Estimation. Methods A total of 130 000 liquid-based cytology specimens collected during the past 6 years were retrospectively analyzed by double-blind method and the infection and histopathological findings of high-risk human papillomavirus (HR-HPV) were followed up . Results A total of 250 cases (0.96%) of LSIL 1, 382 cases of LSIL-H (0.29%), atypical squamous cells, atypical squamous cells (ASC- H) 296 cases (0.23%) and 497 cases (0.38%) of high squamous intraepithelial lesion (HSIL) were enrolled in the study. Combined with histopathological findings and high-risk human papillomavirus infection (45%) were higher than LSIL (10%) and lower than HSIL (66%) in the high grade squamous intraepithelial lesion (CIN2 / 3) (P <0.01), but no significant difference compared with ASC-H (43%) (P> 0.05). Among the low grade squamous intraepithelial lesions, the prevalence of CIN1, LSIL-H (P <0.01). The positive rate of HR-HPV in LSIL-H (79%) was higher than that in LSIL (47%) and ASC-H %), And lower than HSIL (91%), the differences were statistically significant (P <0.01). Conclusion LSIL-H has a high risk of developing high-grade squamous intraepithelial lesion (CIN2 / 3) and infection rate of HR-HPV. The independent diagnosis of LSIL-H is to screen and manage cervical intraepithelial neoplasia , As well as the guidance of diversion of clinical cervical lesions and the risk estimation has a high value.