摘要
目的探讨宫颈脱落细胞学阴性(pap smear negative,Pap-)、人乳头瘤病毒阳性(high risk human papilloma virus positive,HPV+)女性的临床病理特征。方法纳入1 128例Pap-/HPV+女性,阴道镜下可疑部位活检。分析Pap-/HPV+状态下HPV的流行病学特征及宫颈病变的临床病理特征。结果 Pap-/HPV+女性HPV的流行特征,HPV-16所占比例较高(χ2=16. 81,P=0. 000),患者年龄偏大(χ2=20. 72,P=0. 000),单一病毒感染比例较高(χ2=8. 93,P=0. 01)。506例患者接受阴道镜下活检,高度鳞状上皮病变(high grade squamous intraepithelial lesion,HSIL)病例254例(50. 19%),其中7例宫颈浸润癌。HSIL的发生率与年龄有关,年轻患者HSIL比例更高,与年龄呈负相关(r=-0. 254,P=0. 000)。各HPV亚型发生HSIL的比例不同,HPV-16型发生HSIL的比例最高(64. 7%)。与对照组比较,Pap-/HPV+女性感染HPV-16、18、31、33、52、58型显著增加HSIL病变的危险。结论 Pap-/HPV+女性HPV的流行病学特征不同,具有宫颈高级别病变的危险。
Objective To evaluate the cervical pathological features of cytological negative(Pap-)/high-risk human papillomavirus(HR-HPV+)positive women.Methods This study recruited1128women aged20-79years who had undergone cervical screening by liquid-based cytology and HR-HPV test(13HR-HPV types)at Beijing Chaoyang Hospital during Jan2014to Dec2015.Colposcopy and cervical biopsy were carried out in506women.Results The prevalence of HPV in Pap negative/HPV positive(Pap-/HPV+)women was different from that of all HPV positive population at the same time,and the proportion of HPV-16was higher.Pathological features:506patients received colposcopic biopsy,247cases(50.19%)were diagnosed as HSIL,while7patients were diagnosed as invasive cervical cancer.The incidence of HSIL was related to the age.The younger,the higher risk of HSIL.There was a significant negative correlation between the age and the rate(r=-0.254,P=0.000).HSIL incidence was associated with different types of HPV infection,with HPV-16being the highest(64.7%).Compared with the control group,women infected by HPV-16,18,31,33,52and58in the Pap-/HPV+increased significantly the risk of HSIL lesions.Conclusion Overall,50.19%of Pap-/HPV+women had significant cervical lesions.Pap-/HPV+women showed different epidemiological characteristics in HPV and were at high risk of HSIL lesions.
作者
刘军
张雪芳
罗美
张阳
王秋曦
张健欣
王淑珍
Liu Jun;Zhang Xuefang;Luo Mei;Zhang Yang;Wang Qiuxi;Zhang Jianxin;Wang Shuzhen(Department of Gynecology and Obstetrics,Beijing Chaoyang Hospital,Capital Medical University,Beijing100020,China)
出处
《首都医科大学学报》
CAS
北大核心
2018年第6期858-863,共6页
Journal of Capital Medical University
基金
北京市自然科学基金(7122069)
北京市科学技术委员会科技计划(Z131100004013018)~~
关键词
宫颈脱落细胞学
人乳头瘤病毒
高级别宫颈鳞状上皮内瘤变
cervical pathology
human papillomavirus-genotyping
high grade squamous intraepithelial lesion
