HPV-DNA分型检测在不同类型的ASC中的意义

摘要

Objective To disscusa different outcomes of ASC-UC and ASC-H, two subtypes of ASC, and the significance of HPV-DNA genotyping assays in these two subtypes. Methods We reviewed and analyzed colposcopic and biopsy results of 1256 cases of ASC between Jan. 2005 to Dec. 2007, of which 580 cases have results of HPV-DNA genotyping assays. Results In 1256 ASC cases, ASC-US and ASC-H cases account for 90.1% and 9.9% respectively,CIN2 and higher levels diagnosed via colposcopy and cervical biopsy are 8.5% and24.2% respectively(P = 0.000). In ASC-US cases, the infection rate of HPV-DNA high risk types is 67.2%, there is statistic significance among different HPV-DNA results and biopsy pathology (P = 0.000). In ASC-H cases, the infection rate of HPV-DNA high risk types is 47.3%, there is no statistic significance among them (P = 0.054). Conclusion The clinical outcomes of ASC-US and ASC-H are different, we should distinguish and treat. HPV-DNA geantypiag assay is available in ASC-US triage, but Colposcopy is proposed for all ASC-H patients.%目的 了解非典型鳞状细胞(ASC)的两种不同亚型--ASC-US和ASC-H患者临床结局的差异,以及HPV-DNA分型检测在两种不同亚型中的意义.方法 对2005年1月至2007年12月宫颈脱落细胞学判读为ASC的1256例(其中580例同时行HPV-DNA分型检测)行阴道镜及活检,并对上述资料进行分析和总结.结果 在1256例ASC中ASC-US和ASC-H分别占90.1%和9.9%,经阴道镜和宫颈活检病理诊断CIN2及以上的分别为8.5%和24.2%(P=0.000).在ASC-US组HPV高危亚型的感染率为67.2%,不同的HPV-DNA检测结果与阴道镜以及病理检查结果间相比差异有统计学意义(P=0.000).在ASC.H组HPV高危亚型的感染率为47.3%,不同的HPV-DNA检测结果与阴道镜以及病理检查结果间相比差异无统计学意义(P=0.054).结论 ASC的两种不同亚型患者的临床结局不同,应区别对待.HPV-DNA分型检测在ASC-US患者分层处理中有意义,但对于ASC-H患者建议全部行阴道镜检查.