目的:分析贝塞斯达系统报告率,组织学随访,中国安徽省异常细胞学的HPV基因型分布。
方法:根据Bethesda宫颈细胞学报告系统(2014年),宫颈液基细胞学(LBC)结果的回顾性分析,细胞学异常与HPV基因型检测,并立即进行组织学随访。HPV基因型检测进行了15个高危型和6个低危型。术后6个月内的LBC和HPV结果的即刻组织学相关性结果。
结果:6.70%的女性LBC结果异常,ASC/SIL为1.42。细胞学异常的严重组织学结果为ASC-US(18.58%),ASC-H(53.76%),LSIL(16.62%),HSIL(82.07%),SCC/ACa(100.00%),AGC(63.77%)。细胞学异常HPV总阳性率为70.29%,其中ASC-US,ASC-H,LSIL,HSIL,SCC/ACa,AGC为60.78%,80.83%,83.05%,84.93%,84.51%,33.33%。检测到的前三个基因型是HRHPV16、52和58。HSIL和SCC/ACa中最常见的基因型是HPV16。在91名AGC患者中,34.78%为宫颈病变,子宫内膜病变占42.03%。AGC-FN组的HPV阳性率最高,AGC-EM组最低。
结论:Bethesda系统的宫颈细胞学报告率均在CAP实验室的基准范围内。HPV16、52和58是我们人群中最常见的基因型,HPV16感染对宫颈病变的恶性程度较高。在ASC-US结果的患者中,HPV阳性患者的活检检测CIN2+的比率高于HPV阴性患者。
OBJECTIVE: To analyze the Bethesda System reporting rates, histological follow-up, and HPV genotypes distribution of abnormal cytology in Anhui province of China.
METHODS: According to the Bethesda Reporting System of Cervical Cytology (2014), a retrospective analysis of the cervical liquid-based cytology (LBC) results, abnormal cytology with concurrent HPV genotype testing, and immediate histological follow-up. HPV genotype testing was performed for 15 High-risk types and 6 Low-risk types. Immediate histological correlation results within 6 months after the LBC and HPV results.
RESULTS: 6.70% of women with abnormal LBC results, and ASC/SIL was 1.42. The severe histological results in abnormal cytology were ASC-US (18.58%), ASC-H (53.76%), LSIL (16.62%), HSIL (82.07%), SCC/ACa (100.00%), AGC (63.77%). The total HPV-positive rate in abnormal cytology was 70.29%, of which ASC-US, ASC-H, LSIL, HSIL, SCC/ACa, and AGC were 60.78%, 80.83%, 83.05%, 84.93%, 84.51%, 33.33%. The top three detected genotypes were HR HPV 16, 52, and 58. The most commonly detected genotype in HSIL and SCC/ACa was HPV 16. Of the 91 AGC patients, 34.78% were cervical lesions, and 42.03% were endometrial lesions. The HPV-positive rate in the group of AGC-FN was highest and lowest in the group of AGC-EM.
CONCLUSIONS: The Bethesda System reporting rates of cervical cytology were all within the benchmark range of the CAP laboratory. HPV 16, 52, and 58 were the most common genotypes in our population, and HPV 16 infection has a higher degree of malignancy of cervical lesions. Among patients with ASC-US results, HPV positive patients had a higher rate of biopsy-detected CIN2+ than HPV negative patients.