Gonzalez-Bosquet E, Almagro M M, Mora I, Suñol M, Callejo J, Lailla J M
Department of Obstetrics and Gynecology, Sant Joan de Déu University Hospital, Esplugues, Barcelona, Spain.
Eur J Gynaecol Oncol. 2006;27(2):135-8.
To determine the prevalence of human papillomavirus (HPV) using polymerase chain reaction (PCR) in women with abnormal cytology results.
A prospective study of 215 women with abnormal cytology results referred consecutively to the cervical pathology clinic was carried out. A second cervical cytology using the Bethesda System was performed on all the patients to confirm the initial diagnosis, as well as to test for the presence of HPV by PCR and a colposcopy and punch biopsy in cases presenting with an abnormal pattern on colposcopy. The sensivitiy, specificity, and positive and negative predictive value (PPV and NPV) were calculated using 2 x 2 tables.
The women aged 35 years or younger presented a higher percentage of HPV infection (85.6%) than the women over 35 years of age (54%). The highest percentage of women with a positive result for HPV was found in those with a cytological high-grade squamous intraepithelial lesion (HSIL) (85.5%), as compared with 47.4% of the women with a cytological low-grade squamous intraepithelial lesion (LSIL). HPV infection has a high negative predictive value (93.2% of cases) and a high sensitivity (93.5%) for the detection of HSIL by biopsy, although the specificity and positive predictive value were low, 51.5% and 52.1%, respectively.
Patients with cytological HSIL have a high prevalence of HPV infection.
采用聚合酶链反应（PCR）检测细胞学结果异常的女性中人乳头瘤病毒（HPV）的感染率。
对215例连续转诊至宫颈病理门诊、细胞学结果异常的女性进行前瞻性研究。对所有患者再次进行采用贝塞斯达系统的宫颈细胞学检查，以确认初始诊断，并通过PCR检测HPV的存在；对于阴道镜检查结果异常的病例，进行阴道镜检查及组织活检。利用2×2列联表计算敏感度、特异度、阳性预测值和阴性预测值（PPV和NPV）。
35岁及以下的女性HPV感染率（85.6%）高于35岁以上的女性（54%）。细胞学检查为高级别鳞状上皮内病变（HSIL）的女性中HPV检测阳性率最高（85.5%），而细胞学检查为低级别鳞状上皮内病变（LSIL）的女性中这一比例为47.4%。HPV感染对于通过活检检测HSIL具有较高的阴性预测值（93.2%的病例）和较高的敏感度（93.5%），尽管其特异度和阳性预测值较低，分别为51.5%和52.1%。
细胞学检查为HSIL的患者HPV感染率较高。
