人乳头瘤病毒检测在减少宫颈癌前病变手术治疗数量方面的作用。

Role of human papillomavirus testing in reducing the number of surgical treatments for precancerous cervical lesions.

作者信息

Vrtacnik-Bokal E, Rakar S, Jancar N, Mozina A, Poljak M

机构信息

Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slovenia.

出版信息

Eur J Gynaecol Oncol. 2005;26(4):427-30.

PMID:16122194

Abstract

PURPOSE OF INVESTIGATION

To determine whether the addition of the Hybrid Capture II (HC II) test (Digene Corp., Gaithersburg, MD, USA) to cytological, colposcopical and histological results could reduce the number of surgical treatment procedures for precancerous cervical lesions.

METHODS

Surgical treatment of precancerous cervical lesions was performed in 181 women. Priorly, the women were tested for high-risk human papillomavirus (HPV). Sensitivity, specificity, positive and negative predictive value were calculated to assess the performance characteristics of HC II in the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+).

RESULTS

Eighty (44.2%) women had a histological result < CIN 2; 117 (64.6%) women had < CIN 3. Fifty-three (29.3%) women with < CIN 2 tested HPV negative; 69 (38.1%) women with < CIN 3 tested HPV negative (p < 0.05). The sensitivity of HC II for detecting CIN 2+ and CIN 3+ was 76.2% and 87.5%, respectively.

CONCLUSION

A high proportion of women were overtreated probably due to cytological and histological overestimations. HPV testing would reduce the number of unnecessary surgical treatments and should be used as an additional screening tool.

摘要

研究目的

确定在细胞学、阴道镜检查和组织学检查结果基础上增加杂交捕获二代（HC II）检测（美国马里兰州盖瑟斯堡的Digene公司）是否能减少宫颈癌前病变的手术治疗程序数量。

方法

对181名女性进行宫颈癌前病变的手术治疗。此前，这些女性接受了高危人乳头瘤病毒（HPV）检测。计算敏感性、特异性、阳性预测值和阴性预测值，以评估HC II在检测宫颈上皮内瘤变2级或更严重病变（CIN 2+）和3级或更严重病变（CIN 3+）方面的性能特征。

结果

80名（44.2%）女性的组织学检查结果<CIN 2；117名（64.6%）女性<CIN 3。53名（29.3%）CIN 2以下的女性HPV检测为阴性；69名（38.1%）CIN 3以下的女性HPV检测为阴性（p<0.05）。HC II检测CIN 2+和CIN 3+的敏感性分别为76.2%和87.5%。