Clinicopathological significance of atypical squamous epithelium cells which cannot exclude high-grade squamous intraepithelial lesions in cervical cytology / 肿瘤研究与临床

ABSTRACT

Objective To investigate clinicopathological significance of atypical squamous epithelium cells which cannot exclude high grade squamous intraepithelial lesions (ASC-H) in the diagnosis of cervical diseases. Methods The results of age, high-risk human papillomavirus DNA (hrHPV DNA) and cervical biopsy in 496 patients with ASC-H from March 2012 to December 2015 in Shanxi Dayi Hospital were analyzed. Results Among 496 ASC-H cases, the proportion of the patients between 40 and 49 years old was the highest [30.8 ％ (153/496)]. HrHPV DNA was detected in 154 cases, and the positive rate was 79.2 ％(122/154), and the positive rate of patients at the age of 18 to 29 years old was the highest [84.2 ％ (16/19)]. The detection rate of cervical intraepithelial neoplasia (CIN) Ⅱand above lesions in 124 cases with cervical biopsy was 66.9 ％ (83/124), including 100 cases with hrHPV DNA positive (80.6 ％) and 24 cases with hrHPV DNA negative (19.4 ％). There were 71 cases (71.0 ％) of CINⅡ, CIN Ⅲ, early squamous carcinoma and squamous cell carcinomas in 100 hrHPV DNA positive patients with cervical biopsy. There were 12 cases (50.0 ％) of CINⅡ/Ⅲ changes in 24 hrHPV DNA negative patients with cervical biopsy, but none in early squamous carcinoma and squamous cell carcinomas was detected, and there was a significant difference between hrHPV DNA positive and negative patients (χ2=3.857, P< 0.05). The positive predictive value, negative predictive value, sensitivity and specificity of hrHPV DNA detection for diagnosis of CINⅡand above lesions were 85.5 ％, 29.3 ％, 71.0 ％ and 50.0 ％, respectively. Conclusions ASC-H strongly predicts CINⅡand above lesions in cervical cytology. The detection of hrHPV DNA has a high positive predictive value for CINⅡand above lesions.