摘要
目的通过子宫颈细胞学分析未明确诊断意义的不典型鳞状细胞(ASC-US)患者的病理特征及转归情况。方法收集2021年1月~2022年6月在我院门诊进行子宫颈癌机会性筛查且液基薄层细胞学检查(TCT)结果为ASC-US的患者的临床资料,对其临床特征及转归情况进行回顾性分析。结果306例ASC-US患者中,高危型人乳头瘤病毒(HR-HPV)分型检测阳性且行子宫颈组织病理学检查171例,其中,慢性子宫颈炎95例、低级别鳞状上皮内病变(LSIL)46例、高级别鳞状上皮内病变(HSIL)29例、鳞状细胞癌(SCC)1例。细胞学检查结果显示,ASC-US患者中HR-HPV感染率最高的前六位型别分别是HPV52、58、16、18、51、66型。组织学为LSIL的患者,HR-HPV感染率最高的前三位型别依次是HPV52、58、16型;组织学为HSIL的患者,HR-HPV感染率最高的前三位型别则是HPV58、52、16型。ASC-US患者中,HR-HPV感染阳性171例(55.88%),阴性135例(44.12%),且55岁以上年龄段患者的HR-HPV阳性率最高,为32例(69.57%)。HR-HPV单一感染与多重感染患者的组织病理学结果比较,差异具有统计学意义(P<0.05);HR-HPV多重感染中,HPV16/18型合并其他类型感染与非HPV 16/18型感染比较,差异无统计学意义(P>0.05)。期待治疗6~24个月后,≤LSIL组可追溯预后患者77例。以TCT及HR-HPV转阴为预后阴性,其余为预后阳性,结果显示,HR-HPV单一感染与多重感染的预后差异无统计学意义,多重感染中HPV16/18型合并其他类型感染与非HPV 16/18型感染的预后差异亦无统计学意义(P>0.05)。结论ASC-US患者中,特定类型的HR-HPV(HPV58、52、16型)与子宫颈病变的严重程度密切相关。55岁以上患者HR-HPV感染率最高,HR-HPV单一感染与多重感染在组织病理学中存在差异,但预后无明显差异。
Objective To analyze the pathological characteristics and outcomes of patients with atypical squamous cells of undetermined significance(ASC-US)by cervical cytology.Methods The clinical data of ASC-US patients undergoing opportunistic screening of cervical cancer by Thinprep Cytologic Test(TCT)in outpatient department of our hospital from January 2021 to June 2022 were collected,and their clinical characteristics and outcomes were retrospectively analyzed.Results Among 306 patients with ASC-US,171 cases were positive for high-risk human papillomavirus(HR-HPV)typing and cervical histopathological examination,including 95 cases of chronic cervicitis,46 cases of low-grade squamous intraepithelial lesions(LSIL),29 cases of high-grade squamous intraepithelial lesions(HSIL)and 1 case of squamous cell carcinoma(SCC).Cytological results showed that the top six types of HRHPV infection in ASC-US patients were HPV52,58,16,18,51,and 66.In patients with LSIL histological,the top three HR-HPV infection types were HPV52,58 and 16,respectively.In patients with HSIL histological,the top three HR-HPV infection types were HPV58,52 and 16.Among the patients with ASC-US,there were 171 cases(55.88%)were positive for HR-HPV infection and 135 cases(44.12%)were negative,and the positive rate of HR-HPV was the highest in patients over 55 years old[32 cases(69.57%)].There was significant difference in histopathological results between HR-HPV single infection and multiple infection(P<0.05).In HR-HPV multiple infection,there was no significant difference between HPV16/18 combined with other types of infection and non-HPV16/18 infection(P>0.05).After 6~24 months of expected treatment,77 patients in the≤LSIL group had traceable prognosis.The prognosis of TCT and HR-HPV turned negative was negative,and the positive of others was positive.The results showed that there was no statistically significant difference in prognosis between single and multiple HR-HPV infection.There was no significant difference in prognosis between HPV16/18 combined with other types of infection and non-HPV16/18 infection(P>0.05).Conclusion In patients with ASC-US,specific types of HR-HPV(HPV58,52,16)are closely related to the severity of cervical lesions.HR-HPV infection rate was the highest in patients with over 55 years of age.There were differences in histopathology between single and multiple HR-HPV infection,but no significant difference in prognosis.
作者
傅昱娴
张水蓉
FU Yuxian;ZHANG Shuirong(Ward 2,Gynecology Department,Jingzhou Hospital Affiliated to Yangtze University,Jingzhou 434021,China)
出处
《医师在线》
2025年第4期42-46,共5页
Journal of Doctors Online
关键词
子宫颈细胞学
未明确诊断意义的不典型鳞状细胞
病理特征
转归
Cervical cytology
Atypical squamous cell of undetermined significance
Pathological characteristic
Outcome
