Atkins Kristen A, Jeronimo Jose, Stoler Mark H
Department of Pathology, University of Virginia Health System, Charlottesville, Virginia 22908-0214, USA.
Cancer. 2006 Aug 25;108(4):212-21. doi: 10.1002/cncr.21940.
The Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study (ALTS) accumulated information regarding conventional and liquid-based Papanicolaou (Pap) cytology, 2 kinds of human papillomavirus (HPV) DNA testing, cervicography, and colposcopically directed biopsy. The prevalence of squamous cell carcinoma in these women, the efficacy of tests, and the time to detection were reviewed.
The ALTS data base was reviewed for all women with invasive carcinoma. All results of colposcopy, HPV testing, cytology, biopsies, and cervigrams were reviewed for all women in the ALTS trial who were diagnosed with squamous cell carcinoma.
There were 7 diagnoses of invasive cancer (all squamous cell) during the 2 years of the ALTS trial. Although the enrollment studies isolated many high-grade lesions, none of those results were diagnostic of the underlying carcinoma.
The prevalence of squamous cell carcinoma in the setting of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion cytology interpretation appears to be low (approximately 1 per 1000 women in the ALTS trial). Many of the carcinomas were not visible on the ectocervix by cervicography or colposcopy, which may explain in part the paucity of atypical cells detected on the Pap tests and the finding that the presenting cytology, although abnormal, was never diagnostic of cancer. HPV DNA tests were positive in all 7 cancers. Type-specific testing identified HPV type 16 in 6 of 7 cancers and HPV type 18 in 1 of 7 cancers.
意义不明确的非典型鳞状细胞/低度鳞状上皮内病变分流研究（ALTS）积累了有关传统巴氏涂片和液基巴氏涂片细胞学检查、两种人乳头瘤病毒（HPV）DNA检测、宫颈造影以及阴道镜引导下活检的信息。对这些女性中鳞状细胞癌的患病率、检测方法的有效性以及检测时间进行了回顾。
对所有患有浸润性癌的女性的ALTS数据库进行了回顾。对ALTS试验中所有被诊断为鳞状细胞癌的女性的阴道镜检查、HPV检测、细胞学检查、活检和宫颈造影的所有结果进行了回顾。
在ALTS试验的2年期间有7例浸润性癌诊断（均为鳞状细胞癌）。尽管入组研究分离出了许多高级别病变，但这些结果均未诊断出潜在的癌症。
在意义不明确的非典型鳞状细胞或低度鳞状上皮内病变细胞学解释背景下，鳞状细胞癌的患病率似乎较低（在ALTS试验中约为每1000名女性中有1例）。许多癌症通过宫颈造影或阴道镜检查在外宫颈上不可见，这可能部分解释了巴氏涂片检查中检测到的非典型细胞数量稀少，以及尽管细胞学表现异常但从未诊断出癌症的原因。所有7例癌症的HPV DNA检测均为阳性。型特异性检测在7例癌症中的6例中鉴定出HPV 16型，在7例癌症中的1例中鉴定出HPV 18型。
