Cox J T, Schiffman M H, Winzelberg A J, Patterson J M
University of California, Student Health Service, Santa Barbara.
Obstet Gynecol. 1992 Sep;80(3 Pt 1):389-95.
To determine the usefulness of human papillomavirus (HPV) testing as a triage method for predicting which women referred to a colposcopy clinic were most likely to have histologically confirmed cervical intraepithelial neoplasia (CIN).
Papanicolaou tests, ViraPap tests for HPV infection, and colposcopically directed biopsies were performed concurrently on 482 women referred to a student health colposcopy clinic.
The results demonstrated that HPV positivity was associated with a greatly increased likelihood of histologic confirmation of CIN, especially among women with concurrent cytologic findings that were negative or showed only atypical squamous cells of undetermined significance.
Testing for HPV appears to have a role in the triage of students now being referred to our colposcopy clinic. A combination of HPV testing and repeated cytologic screening would provide reasonably sensitive screening for cervical neoplasia while limiting the use of colposcopic services, which are currently overburdened. The eventual usefulness of HPV testing will depend on the cost and availability of colposcopy services, the cost of Papanicolaou tests, the cost and accuracy of HPV tests, and the predictive value of HPV detection in the population being screened.
确定人乳头瘤病毒（HPV）检测作为一种分诊方法，用于预测哪些转诊至阴道镜检查诊所的女性最有可能经组织学确诊为宫颈上皮内瘤变（CIN）的有效性。
对转诊至一家学生健康阴道镜检查诊所的482名女性同时进行巴氏试验、检测HPV感染的ViraPap试验以及阴道镜引导下活检。
结果表明，HPV阳性与CIN组织学确诊的可能性大幅增加相关，尤其是在同时有细胞学检查结果为阴性或仅显示意义不明确的非典型鳞状细胞的女性中。
HPV检测似乎在现在转诊至我们阴道镜检查诊所的学生分诊中发挥作用。HPV检测与重复细胞学筛查相结合，将为宫颈肿瘤提供相当敏感的筛查，同时限制目前负担过重的阴道镜检查服务的使用。HPV检测最终的有效性将取决于阴道镜检查服务的成本和可及性、巴氏试验的成本、HPV检测的成本和准确性以及在被筛查人群中HPV检测的预测价值。
