Salimović-Besić Irma, Bokal Eda Vrtacnik, Poljak Mario, Kocjan Bostjan
Institut za mikrobiologiju, imunologiju i parazitologiju, Klinicki centar Univerziteta u Sarajevu, Bosna i Hercegovina.
Med Arh. 2005;59(1):47-51.
In the detection of precancerous lesions the cervical Papanicolaou smear screening is used in Slovenia and worldwide. Management of patients with repeat abnormal smears (Pap II) represents a great and complex clinical and public health problem. Repeated cytologic examinations are routine procedure in many countries, also in Slovenia, although the sensitivity of Pap smear testing in the detection of cervical intraepithelial neoplasia (CIN) II and III is relatively low. In cases of abnormal squamous cells and mildly dyskaryotic cells the presence of infections with high-risk HPV genotypes is being increasingly used as a complementary method to Pap smear testing. In the study we enrolled 148 cervical samples of women who within two years had three subsequent Pap II smears (abnormal squamous cells or mildly dyskaryotic cells). The prevalence of HPV infections was determined using three molecular tests: Hybrid Capture 2 (hc2) test and two variants of polymerase chain reaction (PCR-PGMY11/PGMY09 and PCR-CPI/CPIIG). HPV infection was detected in 25.7% of women. In women aged < or = 30 years a statistically significant higher prevalence of HPV infections was found (37.8%) than in women aged > 30 years (20.4%). Our findings show that repeat Pap smear as the method of follow-up and detection of precancerous lesions of the observed population do not provide relevant results due to low prevalence of HPV infections in Slovenia, which indirectly indicates low sensitivity and specificity of Pap smear testing. In the detection of HPV infections, molecular methods are thus sensitive screening tests to be used complementary to cytologic tests in women with abnormal squamous cells and mildly dyskaryotic cells.
在癌前病变检测中，宫颈巴氏涂片筛查在斯洛文尼亚乃至全球都有应用。对重复出现异常涂片（巴氏II级）的患者进行管理是一个重大且复杂的临床和公共卫生问题。在许多国家，包括斯洛文尼亚，重复进行细胞学检查是常规程序，尽管巴氏涂片检测在检测宫颈上皮内瘤变（CIN）II级和III级时敏感性相对较低。对于异常鳞状细胞和轻度核异质细胞的情况，高危型人乳头瘤病毒（HPV）基因型感染的检测正越来越多地被用作巴氏涂片检测的补充方法。在本研究中，我们纳入了148例女性的宫颈样本，这些女性在两年内连续三次巴氏涂片结果为II级（异常鳞状细胞或轻度核异质细胞）。使用三种分子检测方法确定HPV感染率：杂交捕获2（hc2）检测以及聚合酶链反应的两种变体（PCR-PGMY11/PGMY09和PCR-CPI/CPIIG）。在25.7%的女性中检测到HPV感染。年龄≤30岁的女性中HPV感染率（37.8%）在统计学上显著高于年龄>30岁的女性（20.4%）。我们的研究结果表明，由于斯洛文尼亚HPV感染率较低，作为所观察人群癌前病变随访和检测方法的重复巴氏涂片并不能提供相关结果，这间接表明巴氏涂片检测的敏感性和特异性较低。因此，在检测HPV感染时，分子方法是对异常鳞状细胞和轻度核异质细胞女性进行细胞学检测的补充性敏感筛查试验。
