宫颈细胞学为ASCUS的临床意义及处理措施探讨.docVIP

宫颈细胞学为ASCUS的临床意义及处理措施探讨 　　[摘要] 目的 分析宫颈细胞学为ASCUS的临床意义及处理措施。方法 整群选择2014年5月―2015年3月来该院妇科门诊就诊的156例宫颈细胞学为ASCUS的患者为研究对象，对所有患者进行阴道镜检查及宫颈组织活检，同时对其中100名患者进行了HPV（人乳头瘤病毒）的高危检测，分析其检查结果。结果 156名ASCUS患者中58名宫颈组织病理提示宫颈上皮内瘤变，发生率为37.18%，其中高级别CIN及浸润癌发生率为23.72%，阴道镜诊断出高级别CIN及浸润癌为24例，符合率为64.86%。HPV阳性者CIN检出率82.89%，4例浸润癌均为HPV阳性，明显高于阴性组。结论 宫颈细胞学为ASCUS提示可能发生宫颈上皮内瘤变，应该警惕其高级别CIN和浸润癌的可能。联合应用阴道镜检查可以明显提高宫颈病变的检出情况。高危HPV是ASCUS分流管理的一种有效手段，可以明显提高宫颈上皮内瘤变的检出。 　　[关键词] ASCUS；宫颈细胞学；阴道镜；组织活检 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）06（b）-0025-03 　　[Abstract] Objective To analyze the clinical significance and treatment measures of cervical cytology for ASCUS. Methods Gropu selection May 2014 to March 2015 to gynecological outpatients from 156 cervical cytology ascus patients as the research object， for all patients of colposcopy and cervical biopsy， detection of high risk HPV （human papilloma virus） of the 100 patients at the same time， analysis the examination results. Results 156 patients with ASCUS 58 cervical pathological prompt cervical intraepithelial neoplasia， incidence of 37.18%， the high grade CIN and invasive carcinoma incidence was 23.72% and colposcopy in the diagnosis of a high grade cervical intraepithelial neoplasia （CIN） and invasive carcinoma in 24 cases， in line with the rate was 64.86%. HPV positive detection rate of CIN was 82.89%， 4 cases of invasive carcinoma were HPV positive， significantly higher than the negative group. Conclusion Cervical cytology was ASCUS suggesting that the occurrence of cervical intraepithelial neoplasia， should be alert to its high level of CIN may and invasive carcinoma. Improved detection of cervical lesions combined with colposcopy. HPV is an effective means of risk management of ASCUS shunt， can significantly improve the detection of cervical intraepithelial neoplasia. 　　[Key words] ASCUS； Cervical cytology； Colposcopy； Biopsy 　　宫颈癌是妇女疾病中常见的恶性肿瘤，其发病率位居女性恶性肿瘤中的第二位，严重威胁女性的生命健康。大量临床试验表明，宫颈癌是一种经过早期筛查、早期发现、早期临床医学治疗可以明显降低其发病率及死亡率的疾病[1-3]。宫颈细胞学检查是筛查