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目的:探讨性质未定的宫颈不典型鳞状上皮细胞(AS-CUS)阴道镜检查及HPV-DNA检测的临床价值。方法:对86例宫颈细胞学诊断为AS-CUS的患者进行高危HPV-DNA检测和电子阴道镜检查及多点活检并复查、随访2年。结果:86例宫颈病理结果:炎症28例(32.6%),CINⅠ41例(47.7%),CINⅡ11例(12.8%),CINⅢ5例(5.8%),原位癌1例(1.2%),阴道镜检查高度CIN患者Reid评分3分或以上者占100.0%(17/17),低度CIN或以下患者Reid评分3分或以上者仅占14.6%(6/41),两者差异有统计学意义(P<0.01)。高度CIN患者的高危HPV阳性率为94.1%(16/17),低度CIN或以下患者的高危HPV阳性率为63.4%(26/41),两者差异有统计学意义(P<0.05)。结论:AS-CUS的患者中潜存着宫颈高级别的CIN病变及宫颈早期浸润癌,宫颈高度CIN病变与高危HPV感染密切相关。正确评估阴道镜图像及在阴道镜下定位活检准确性高,可避免漏诊。
Objective: To explore the clinical value of colposcopy and HPV-DNA detection of unspecified cervical atypical squamous cell (AS-CUS). Methods: Eighty-six patients with cervical cytology diagnosed as AS-CUS underwent high-risk HPV-DNA test, electronic colposcopy and multiple biopsy. The patients were followed up for 2 years. RESULTS: The pathological findings of 86 cases of cervix were as follows: inflammation in 28 cases (32.6%), CINⅠ in 41 cases (47.7%), CINⅡ in 11 cases (12.8%), CINⅢ in 5.8% and in situ carcinoma in 1 case (1.2% Patients with high CIN had a Reid score of 3 or higher (100.0%, 17/17), only 14.6% (6/41) had a Reid score of 3 or higher in patients with low CIN or less, with a statistically significant difference P <0.01). The positive rate of high risk HPV in patients with high CIN was 94.1% (16/17), while the positive rate of high risk HPV was 63.4% (26/41) in patients with low CIN, the difference was statistically significant (P <0.05). CONCLUSIONS: Cervical high grade CIN lesions and early invasive carcinoma of the cervix are latent in patients with AS-CUS. Cervical high-grade CIN lesions are closely related to high-risk HPV infection. Correct assessment of colposcopy images and colposcopy Positioning biopsy accuracy, to avoid missed diagnosis.