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目的:探讨宫颈细胞学正常但高危型HPV感染妇女的宫颈病理结局。方法:回顾分析2014年1月~12月就诊于湖北省妇幼保健院妇科门诊的30岁以上行宫颈细胞学+Cervista高危型HPV联合筛查妇女的临床资料,对细胞学正常但高危型HPV感染且行阴道镜检查的218例妇女取活组织检查,分析其病理结局。结果:218例患者中,宫颈病变占27.5%(60/218),其中宫颈低级别鳞状上皮内病变占11.0%(24/218),宫颈高级别鳞状上皮内病变占13.8%(30/218),宫颈浸润癌占2.8%(6/218)。HPV A9组感染共141例,其中CINⅡ/Ⅲ及以上病变21.3%(30/141),HPV A9组阳性与A9组阴性者比较,CINⅡ/Ⅲ及以上病变检出率比较,差异有统计学意义(P<0.05)。结论:即使细胞学检查阴性,对宫颈高危型HPV检测及阳性结果尤其是A9组阳性,应高度重视,立即行阴道镜检查以早期发现宫颈高级别鳞状上皮内病变及宫颈浸润癌。
Objective: To investigate the cervical pathological outcome of women with cervical cytology normal but high risk HPV infection. Methods: The clinical data of cervical cytology + Cervista high-risk HPV screening women over 30 years old attending gynecology clinic of Hubei Maternal and Child Health Hospital from January to December 2014 were retrospectively analyzed. The cytology of normal but high-risk HPV infection And 218 cases of colposcopy examination of women take biopsy to analyze the pathological outcome. Results: Of the 218 patients, cervical lesions accounted for 27.5% (60/218), with low grade squamous intraepithelial lesion in 11.0% (24/218) and high grade squamous intraepithelial lesion in 13.8% (30 / 218), cervical cancer accounted for 2.8% (6/218). There were 141 cases of HPV A9 infection, 21.3% (30/141) cases of CINⅡ / Ⅲand above, HPV A9 group positive and A9 group negative, the detection rate of CINⅡ / Ⅲand above was statistically different (P <0.05). CONCLUSIONS: Even if cytology is negative, high-risk cervical HPV testing and positive results, especially A9 positive, should be given high priority. Colposcopy should be performed immediately to detect early high-grade squamous intraepithelial lesions and invasive cervical cancer.