| Background and Objective: Atypical squamous cells of undetermined significance(ASCUS) is the most common abnomal result in cervical cytology. ASCUS was resulted ofhuman papillomavirus (HPV) infection, the potential cervical intraepithelial neoplasia orcancer. In addition, atypical metaplasia, repairation, dyskeratosis and atrophic cell changeswere associated with ASCUS. Since ASCUS contains such wide range of diseases, trige andtreatment of these patients maybe puzzle the clinicians. In this study, the clinical data of130patients with ASCUS were analyzed by detail, and the deeply understanding about thedisease was obtained. This study provided theoretical guidance for clinical treatment, andhelped finding the best clinical treatment program.Methods:（1）Formulate and fill out the questionnaire:All130cases were diagnosed with ASCUS by liquid-based cytology test according toclassify method of TBS. The outpatients and inpatients were included, and they filled out thequestionnaire. The content of questionnaire included: age, occupation, clinic symptoms, theage of first contact, number of sexual partners, times of gestation and parity, delivery mode,whether placing IUD, the history of genital warts in herself or her partner.（2）The collection of clinical data:All of the patients received high-risk HPV (hr-HPV) test, colposcopic inspections,reformeded Reid＇ s colposcopic index score and cervical biopsies for pathologicalexamination.（3）Statistical analysis:EpiData3.02software was adopted to establish the database, and the SPSS17.0statistical software was used to analyze the data. Descriptive analysis of generalinformation. The data was analyzed by using chi-square analysis to investigate thedistribution histopathology in different age groups and to investigate the relationshipbetween histopathologic grade and reformed Reid＇s colposcopic index score, hr-HPVinfection and viral load(=0.05). The logistic repression analysis screen the causes of thehistopathologic grade and the hr-HPV infection(入=0.05,出=0.10). Results:1.The age of130ASCUS patients was between20~66years old, median was38.00years old, mean age was (38.85±8.745) years old, the majority of patients werefarmers and business people, accounted for32.31%and20.00%, respectively. Most ASCUSpatients were detected in common physical exam, accounted for43.84%(57/130). The ageof first contact concentrated in21~25years old. The age of hr-HPV infection concentratedin30~49years old. The patients who had more than3times pregnant accounted for51.53%(67/130).2. The pathology of130ASCUS patients included31cases of normal andinflammation(23.90%),29cases of CINⅠ(22.30%),14cases of CINⅡ(10.80%),55casesof CINⅢ or cervical carcinoma in situ (42.30%), and1case of invasive cervical carcinoma(0.80%). By statistic analysis, the pathological results and the pathological grade (＜CINⅡand≥CIN Ⅱ) had no significant differences among age groups (2=14.699,P=0.547>0.00625,2=4.983, P=0.289>0.05).3. The reformed Reid＇s colposcopic index score of130ASCUS patients had nosignificant differences among age groups(2=6.533, P=0.887>0.00625). Comparing RCIwith pathological outcome, coincidence rate was38.46%(50/130). Including one gradedeviation, the coincidence rate was86.92%(113/130).4. The most of130ASCUS patients associated with hr-HPV infection, HPV positiverate was90.00%(117/130). Hr-HPV infection rate increased significantly with the increaseof pathological grade.5. The colposcopy used to detect the CIN of ASCUS, its sensitivity was98.99%(98/99),specificity was51.61%(16/31). The hr-HPV used to detect the CIN of ASCUS, itssensitivity was96.97%(96/99), specificity was32.26%(10/31).6. There were significant differences in the level of hr-HPV viral load between the lowand high-level cervical lesions (2=14.620, P=0.012＜0.05).7. The low and high-level cervical lesions determined the treatment and prognosis ofpatients. The logistic repression analysis arrived at the risk factors for high level cervicallesions (≥CINⅡ) correlated with gestation and hr-HPV infection. The logistic repression analysis of high-risk HPV infection arrived at placing intrauterine device was3.503times aswithout palcing it.Conclusions:1. Patients are diagnosed with ASCUS by liquid-based cytology test according toclassify method of TBS have potential risk of high level cervical lesions, which can happenat any age.2. The risk of developing high level cervical lesions correlats with gestation.3. Hr-HPV infection may increase the risk of developing high level cervical lesions,and correlats with hr-HPV viral load.4. The reformeded Reid＇s colposcopic index score has good sensitivity and specificityas the clinical triage method of ASCUS, which is superior to hr-HPV testing5. Placing IUD is risk factor for hr-HPV infection, which is probably correlated tosexual contact directly. |
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