Jain S, Tseng C J, Horng S G, Soong Y K, Pao C C
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Gynecol Oncol. 2001 Jul;82(1):177-80. doi: 10.1006/gyno.2001.6241.
The goal of this study was to determine/evaluate the negative predictive value of human papillomavirus (HPV) testing following conization of cervix uteri.
A prospective analysis was undertaken on 79 cone biopsies of women with high-grade lesions (cervical intraepithelial neoplasia (CIN) III). HPV testing was performed on cervical smears before and after conization. We correlated the margin status (defined as positive cone margin or endocervical curettage status) and positive conization HPV status with the residual disease in a hysterectomy specimen. A Digene II kit was used to perform HPV testing. HPV detection was done by Hybrid Capture assay.
Of the 79 patients, 47(59.5%) had positive margins after conization. HPV testing was positive in 37 cases (78.7%) and negative in 10 cases (21.3%). Residual disease was found in 31 of 47 (66%) postconization hysterectomy specimens. No residual lesions were found in HPV-negative cases. Of the 32 cases with negative margins following conization, HPV testing was negative in 25 cases (78%) and was positive in 7 cases (22%). Among these 25 cases with negative HPV tests, no residual lesion was detected, and in 7 HPV-positive cases, only one residual lesion was found.
HPV testing is potentially an effective tool in predicting residual dysplasia after conization and could potentially assist in the decision between hysterectomy and conservative follow-up in women with CIN III.
本研究的目的是确定/评估子宫颈锥形切除术后人乳头瘤病毒（HPV）检测的阴性预测值。
对79例患有高级别病变（宫颈上皮内瘤变（CIN）III级）的女性进行锥形活检，进行前瞻性分析。在锥形切除术前和术后对宫颈涂片进行HPV检测。我们将切缘状态（定义为切缘阳性或宫颈管刮除状态）和锥形切除HPV阳性状态与子宫切除标本中的残留疾病进行关联。使用Digene II试剂盒进行HPV检测。通过杂交捕获试验进行HPV检测。
79例患者中，47例（59.5%）锥形切除术后切缘阳性。HPV检测阳性37例（78.7%），阴性10例（21.3%）。47例锥形切除术后子宫切除标本中有31例（66%）发现残留疾病。HPV阴性病例中未发现残留病变。在锥形切除术后切缘阴性的32例病例中，HPV检测阴性25例（78%），阳性7例（22%）。在这25例HPV检测阴性的病例中，未检测到残留病变，在7例HPV阳性病例中，仅发现1例残留病变。
HPV检测可能是预测锥形切除术后残留发育异常的有效工具，并可能有助于CIN III级女性子宫切除和保守随访之间的决策。
