459例宫颈高级别鳞状上皮内病变患者HPV感染特点及高危HPV阴性的筛查特征分析

张晓林; 任玉香; 冯顺; 朱燕妮; 徐燕

doi:10.16016/j.2097-0927.202106037

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459例宫颈高级别鳞状上皮内病变患者HPV感染特点及高危HPV阴性的筛查特征分析

临床医学 | 更新时间：2026-01-09

- 459例宫颈高级别鳞状上皮内病变患者HPV感染特点及高危HPV阴性的筛查特征分析
- Features of HPV infection and screening characteristics of high-risk HPV negative in patients with cervical high-grade squamous intraepithelial lesion: a retrospective analysis of 459 cases
- 陆军军医大学学报 2022年44卷第3期页码：253-258
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院妇产科
- 作者简介：
  
  [徐燕，E-mail：xuyancq85@163.comXU Yan, E-mail: xuyancq85@163.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202106037
  中图分类号： R373.9;R730.43;R737.33
- 收稿：2021-06-04，
  
  修回：2021-11-11，
  
  纸质出版：2022-02-15
- 稿件说明：
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张晓林, 任玉香, 冯顺, 等. 459例宫颈高级别鳞状上皮内病变患者HPV感染特点及高危HPV阴性的筛查特征分析[J]. 陆军军医大学学报, 2022,44(3):253-258.

Xiaolin ZHANG, Yuxiang REN, Shun FENG, et al. Features of HPV infection and screening characteristics of high-risk HPV negative in patients with cervical high-grade squamous intraepithelial lesion: a retrospective analysis of 459 cases[J]. Journal of Army Medical University, 2022, 44(3): 253-258.
张晓林, 任玉香, 冯顺, 等. 459例宫颈高级别鳞状上皮内病变患者HPV感染特点及高危HPV阴性的筛查特征分析[J]. 陆军军医大学学报, 2022,44(3):253-258. DOI： 10.16016/j.2097-0927.202106037.

Xiaolin ZHANG, Yuxiang REN, Shun FENG, et al. Features of HPV infection and screening characteristics of high-risk HPV negative in patients with cervical high-grade squamous intraepithelial lesion: a retrospective analysis of 459 cases[J]. Journal of Army Medical University, 2022, 44(3): 253-258. DOI： 10.16016/j.2097-0927.202106037.

摘要

目的

探讨高危人乳头瘤病毒(high-risk human papillomavirus，HR-HPV)感染特点及其中HR-HPV阴性的筛查特征。

方法

对我院妇科门诊2019年1月至2020年8月病理诊断为宫颈高级别鳞状上皮内病变(high grade squamous intraepithelial lesion，HSIL)患者的筛查结果进行回顾性分析，比较HR-HPV、液基薄层细胞学检查(thinprep cytologic test，TCT)以及二者联合筛查异常的阳性检出率。分析避免HR-HPV阴性的HSIL患者漏诊要点。

结果

459例HSIL患者中HR-HPV阳性率91.94%；单一感染占71.90%，多重感染占22.22%；单一感染中阳性率最高的是16型(45.76%)。3种方法初筛分流的阳性率分别为77.34%、64.27%和82.79%，三者比较差异有统计学意义(

0.01)。HR-HPV阴性组中TCT高于不能明确意义的非典型鳞状细胞(atypical squamous cells of undetermined significance

ASCUS)有25例(67.57%)；3例(8.11%)TCT为ASCUS及9例(24.32%)TCT低于ASCUS的均因临床症状转诊阴道镜；6例阴道镜初诊正常的均有TCT异常。

结论

HSIL患者中HPV感染以HR-HPV感染及单一型感染居多。HR-HPV和TCT联合筛查的阳性率最高。HR-HPV阴性的HSIL患者通常有明显的临床症状和TCT异常。

Abstract

Objective

To investigate the infection features of high-risk human papillomavirus (HR-HPV) and screening characteristics of HR-HPV-negative cases in patients with cervical high-grade squamous intraepithelial lesion (HSIL).

Methods

A retrospective analysis was conducted on the screening results of 459 patients who were pathologically diagnosed as cervical HSIL in our hospital from January 2019 to August 2020. The positive detection rates of HR-HPV test

thinprep cytologic test (TCT)

and their joint screening were compared among the patients

and the analysis of key points to avoid missed diagnosis were conducted in HR-HPV negative cases.

Results

Among the 459 HSIL patients

the single subtype infection accounted for 71.90% (330 cases)

multiple infection 22.22% (102 cases); the positive rate of HR-HPV was 91.94% (422 cases)

and the monotype infection with the highest positive rate was HPV subtype 16 (45.76%). The positive detection rates of the 3 tests were 77.34%

64.27% and 82.79% respectively

with significant difference (

0.01). Moreover

25 cases (67.57%) in the HR-HPV negative group had worse than ASCUS results of TCT

while 3 cases (8.11%) with ASCUS and 9 cases (24.32%) with negative TCT results were referred to colposcopy due to clinical symptoms

and 6 HR-HPV negative cases with normal colposcopy showed abnormal TCT results.

Conclusion

HR-HPV infection and monotype infection are predominant in cervical HSIL patients. The combined screening of HR-HPV and TCT has the highest positive diagnostic rate

while the HR-HPV negative patients usually have obvious clinical symptoms and TCT abnormalities.

关键词

Keywords

references

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