宫颈细胞学诊断低度上皮内瘤变的临床处理探讨

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目的:探讨宫颈细胞学诊断低度上皮内瘤变的意义及临床处理方法。方法:对2010年5月~2011年11月在广东省中医院就诊并经TCT检查为LSIL的195例女性病例进一步行HPV-DNA-PCR检测及阴道镜检查,观察其最终病理结果的构成及在不同年龄阶段的分布差异。结果:在195例LSIL患者中,高危HPV阳性144例(73.8%),病理诊断为癌前病变及癌者共87例(60.4%);高危HPV阴性51例(26.2%),病理诊断为癌前病变及癌者共8例(15.7%)。在35岁以下的93例中,病理诊断为癌前病变及癌者共43例(46.2%);在35~45岁的69例中,病理诊断为癌前病变及癌者共41例(69.9%);45岁以上33例中,病理诊断为癌前病变及癌者共11例(33.3%)。结论:在TCT诊断为LSIL的患者中,高危HPV阳性与高危HPV阴性患者的宫颈病变检出率差异有统计学意义,不同年龄段之间宫颈病变检出率差异有统计学意义,临床处理方法及随访计划的制定与年龄及HPV感染情况有关。 Objective: To investigate the significance and clinical treatment of cervical cytology in the diagnosis of low grade intraepithelial neoplasia. Methods: HPV-DNA-PCR and colposcopy were performed on 195 female patients who were admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2010 to November 2011 and who were diagnosed as LSIL by TCT. The final pathological results were also analyzed. Discrepancy in different age groups. RESULTS: Among 195 LSIL patients, 144 (73.8%) were high-risk HPVs, 87 (60.4%) were pathologically diagnosed as precancerous lesions and cancers, 51 (26.2%) were high-risk HPVs, Pre-lesion and cancer were a total of 8 cases (15.7%). Among the 93 cases under 35 years of age, 43 cases (46.2%) were diagnosed as precancerous lesions and cancers, and 41 cases (69.9%) were pathologically diagnosed as precancerous lesions and cancers in 35 cases aged 35-45 years %). Among 33 cases over 45 years of age, 11 cases (33.3%) had pathological diagnosis of precancerous lesions and cancers. Conclusion: The detection rate of cervical lesions in patients with high-risk HPV-positive and high-risk HPV-negative patients was significantly different among the patients diagnosed as LSIL by TCT. The detection rate of cervical lesions among different age groups was statistically significant. The clinical treatment methods And follow-up plan and the development of age and HPV infection.
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