[Objective] To investigate the clinical significance of and treatment for atypical squamous cells of undetermined significance (ASCUS) diagnosed by cervical cytology.[Methods] A total of 1658 patients with ASCUS tested by thin-prep-liquid-based cytology test (TCT) underwent HR-HPV testing,colposcopy and cervical biopsies.[Results] In ASCUS patients,the positive rates of CIN and invasive cancer in HR-HPV positive group and negative group were 68.22％ and 8.74％,respectively.The difference was statistically significant (P ＜0.001).Incidence of CIN and invasive carcinoma in HR-HPV-positive group was about 22 fold of that in HR-HPV-negative group [OR (95％CI)=22.4065].There were 842 cases diagnosed as CIN and invasive cancer by colposcopy,the detection rate was 88.82％ (802/903),of which 134 cases of high-grade CIN and invasive cancer were diagnosed with detection rate of 87.01％ (134/154).[Conclusion] A combination of HR-HPV testing and colposcopy shows a good positive predictive value,high sensitivity and low misdiagnosis rate with high promotional value in diagnosis of cervical precancerous lesion especially high-grade CIN,and invasive carcinoma.%目的 探讨宫颈液基细胞学检查(TCT)报告为性质未定的不典型鳞状细胞(ASCUS)的临床意义及处理.方法 对宫颈薄层液基细胞学诊断为ASCUS的1658例患者分别进行HR-HPV检测、阴道镜下活组织检查.结果 在ASCUS患者中,HR-HPV阳性组CIN及浸润癌的检出率为68.22％,在HR-HPV阴性组CIN及浸润癌的检出率为8.74％,两组间差异有显著性(P ＜0.001).阳性组发生CIN和浸润癌的风险是阴性组的22.4065倍[OR(9％CI)=22.4065].阴道镜拟诊CIN和浸润癌842例,检出率为88.82％(802/903),其中高级别CIN和浸润癌134例,检出率为87.01％(134/154).结论 阴道镜联合HR-HPV检测在宫颈癌前病变,特别是在高级别宫颈上皮内瘤变及浸润癌诊断中阳性预测值较理想,敏感性较好,漏诊率低,具有较高的推广价值.
展开▼
