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目的:探讨宫颈细胞学检查结果为ASC-US(未明确意义的不典型鳞状上皮细胞)的处理及临床意义。方法:对286例液基细胞学检查(TCT)诊断为ASC-US的患者同时行高危型HPV-DNA检测和阴道镜下活检。结果:286例宫颈细胞学ASC-US诊断中,HPV阳性207例,占72.4%(207/286);HPV阴性79例,占27.6%(79/286);病理检查结果为:207例HPV阳性ASC-US患者组中,炎症80例(38.6%)、尖锐湿疣59例(28.5%)、宫颈上皮内瘤变(CIN)65例(31.4%)、宫颈浸润癌3例(1.5%);79例HPV阴性ASC-US患者组中,炎症56例(70.9%)、尖锐湿疣16例(20.2%)、CIN 7例(8.9%)、未检出宫颈浸润癌。高危型HPV阳性ASC-US患者组中CIN的检出率(31.4%)明显高于阴性组(8.9%),且差异具有统计学意义。结论:对ASC-US患者的处理应给予足够的重视,HPV DNA检测可将CIN从ASC-US中有效地检出,从而减少经阴道镜下活检以明确子宫颈癌前病变的病例数。
Objective: To investigate the clinical significance of cervical cytology as ASC-US (atypical squamous cell with undefined significance). Methods: A total of 286 patients diagnosed as ASC-US by liquid-based cytology (TCT) underwent both high-risk HPV DNA test and colposcopic biopsy. Results: Of the 286 cervical cytology ASC-US diagnoses, 207 were positive for HPV (72.4%, 207/286), 79 were HPV-negative (27.6%, 79/286), and 207 were HPV positive In the ASC-US group, 80 cases (38.6%) of inflammation, 59 cases (28.5%) of condyloma acuminatum, 65 cases (31.4%) of cervical intraepithelial neoplasia (CIN) and 3 cases Cases of HPV-negative ASC-US patients, inflammation in 56 cases (70.9%), genital warts in 16 cases (20.2%), CIN in 7 cases (8.9%), no cervical invasive carcinoma was detected. The detection rate of CIN (31.4%) in high-risk HPV-positive ASC-US patients was significantly higher than that in negative patients (8.9%), and the difference was statistically significant. CONCLUSIONS: Adequate attention should be paid to the treatment of ASC-US patients. HPV DNA test can effectively detect CIN from ASC-US, so as to reduce the number of colposcopic biopsy to confirm the precancerous lesions of cervical cancer.