ASCUS患者发生宫颈高级别病变高危因素分析(1)
摘 要：目的 探讨不能明确意义的非典型鳞状细胞患者发生CINⅡ 及其以上宫颈病变的影响因素。方法 通过完善設计的调查量表对我院门诊就诊行宫颈液基细胞学检查(TCT)为ASCUS的236例患者进行回顾性资料收集，同时行人乳头瘤状病毒(HPV)基因型检测，和阴道镜检查+宫颈活检，对相关危险因素进行单因素和多因素分析。结果 236例ASCUS病变中，病理证实CIN共68例(28.81%)，其中CINⅡ及以上检出36例，占总病例数的15.25%。236例ASCUS病例中，高危型HPV阳性率为55.51%，高危型HPV阳性及高危型HPV阴性组CINⅡ及以上病变检出率分别为25.19%、2.86%，差异有统计学意义(P<0.05)。高危型HPV检测CINⅡ及其以上的敏感性达91.67%，阴性预测值达97.14%。单因素分析中年龄、初次性生活年龄、流产次数、HR-HPV与CINⅡ及其以上密切相关。Logistic多因素回归分析的结果表明初次性生活年龄、流产次数、HR-HPV是宫颈CINⅡ及其以上的高危因素。结论 高危型HPV检测是ASCUS患者分流的重要指标，尤其是年龄在30～50岁。初次性生活年龄≤20岁、流产次数>2次、HR-HPV是ASCUS患者发生宫颈高度病变的独立的高危因素。
, 百拇医药
关键词：非典型鳞状细胞；宫颈上皮内瘤变；人乳头瘤状病毒；危险因素；CINⅡ
中图分类号：R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.026文章编号：1006-1959(2018)23-0096-05
Abstract：Objective To investigate the influencing factors of CINⅡ and above cervical lesions in atypical squamous cell patients without definite significance.Methods A total of 236 patients with cervical liquid-based cytology (TCT) as ASCUS were collected retrospectively by a well-designed survey scale，at the same time， the detection of (HPV) genotype of pedestrian papillomavirus and colposcopy examination+cervical biopsy，the related risk factors were analyzed by univariate and multivariate analysis.Results Of the 236 cases of ASCUS lesions， 68 cases (28.81%) were confirmed by pathology as CIN.36 cases of CINⅡ and above were detected， accounting for 15.25% of the total cases.In 236 cases of ASCUS， the positive rate of high-risk type HPV was 55.51%.The detection rates of CINⅡ and above in high risk HPV positive group and high risk HPV negative group were 25.19%，2.86%， respectively，the difference was statistically significant (P<0.05).The sensitivity of high risk HPV for detecting CINⅡ and above was 91.67% and the negative predictive value was 97.14%.Univariate analysis showed that age， age of first sexual life， number of miscarriages and HR-HPV were closely related to CINⅡ and above.The results of Logistic multivariate regression analysis showed that the age of first sexual life， the number of miscarriages and HR-HPV were high risk factors for cervical CINⅡ and above.Conclusion High-risk HPV is an important indicator of shunt in ASCUS patients， especially in 30～50 years old.The age of first sexual life ≤ 20 years old， and the number of miscarriages more than 2，HR-HPV were independent risk factors for high cervical lesions in patients with ASCUS.
, 百拇医药
Key words：Atypical squamous cells；Cervical intraepithelial neoplasia；Human papillomavirus；Risk factors；CINⅡ
近年来宫颈癌(cervical cancer)的发病率一直居高不下，且发病人群呈现年轻化趋势，严重威胁女性健康。宫颈癌的筛查显得尤为重要，在宫颈癌筛查中，不能明确意义的非典型鳞状细胞(atypical squamous cells of undetermined significance，ASCUS)是最常见的异常细胞学诊断，约占5%[1]。ASCUS是一种排除性的诊断，提示可能存在病变，但并不能明确诊断为异常结果[2]，因此，ASCUS的临床治疗是一个棘手的问题，本文回顾性分析236例ASCUS患者的临床资料，通过统计学分析得出影响ASCUS患者发生高级别病变及其以上的危险因素，旨在为临床ASCUS患者提供最佳处理。, 百拇医药(国萍 李青)
, 百拇医药
关键词：非典型鳞状细胞；宫颈上皮内瘤变；人乳头瘤状病毒；危险因素；CINⅡ
中图分类号：R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.026文章编号：1006-1959(2018)23-0096-05
Abstract：Objective To investigate the influencing factors of CINⅡ and above cervical lesions in atypical squamous cell patients without definite significance.Methods A total of 236 patients with cervical liquid-based cytology (TCT) as ASCUS were collected retrospectively by a well-designed survey scale，at the same time， the detection of (HPV) genotype of pedestrian papillomavirus and colposcopy examination+cervical biopsy，the related risk factors were analyzed by univariate and multivariate analysis.Results Of the 236 cases of ASCUS lesions， 68 cases (28.81%) were confirmed by pathology as CIN.36 cases of CINⅡ and above were detected， accounting for 15.25% of the total cases.In 236 cases of ASCUS， the positive rate of high-risk type HPV was 55.51%.The detection rates of CINⅡ and above in high risk HPV positive group and high risk HPV negative group were 25.19%，2.86%， respectively，the difference was statistically significant (P<0.05).The sensitivity of high risk HPV for detecting CINⅡ and above was 91.67% and the negative predictive value was 97.14%.Univariate analysis showed that age， age of first sexual life， number of miscarriages and HR-HPV were closely related to CINⅡ and above.The results of Logistic multivariate regression analysis showed that the age of first sexual life， the number of miscarriages and HR-HPV were high risk factors for cervical CINⅡ and above.Conclusion High-risk HPV is an important indicator of shunt in ASCUS patients， especially in 30～50 years old.The age of first sexual life ≤ 20 years old， and the number of miscarriages more than 2，HR-HPV were independent risk factors for high cervical lesions in patients with ASCUS.
, 百拇医药
Key words：Atypical squamous cells；Cervical intraepithelial neoplasia；Human papillomavirus；Risk factors；CINⅡ
近年来宫颈癌(cervical cancer)的发病率一直居高不下，且发病人群呈现年轻化趋势，严重威胁女性健康。宫颈癌的筛查显得尤为重要，在宫颈癌筛查中，不能明确意义的非典型鳞状细胞(atypical squamous cells of undetermined significance，ASCUS)是最常见的异常细胞学诊断，约占5%[1]。ASCUS是一种排除性的诊断，提示可能存在病变，但并不能明确诊断为异常结果[2]，因此，ASCUS的临床治疗是一个棘手的问题，本文回顾性分析236例ASCUS患者的临床资料，通过统计学分析得出影响ASCUS患者发生高级别病变及其以上的危险因素，旨在为临床ASCUS患者提供最佳处理。, 百拇医药(国萍 李青)