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[高危型人乳头瘤病毒检测在宫颈癌前病变筛查及管理中的作用]

[Role of high-risk human papillomavirus testing in the screening and management of cervical cancer precursors].

作者信息

Jin Ying, Pan Ling-ya

机构信息

Department of Obstetrics and Gynecology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Oct;29(5):691-6.

Abstract

Human papillomavirus (HPV) infection is an essential cause of cervical cancer. HPV testing therefore may maximize the clinical benefits of cervical screening and abnormal cervical cytology management. A negative HPV test in combination with a normal Pap test result in women age 30 years or older allows the safe extension of the cervical screening interval to 3 years. However, because HPV infection is common in young women and is usually transient, HPV testing is not recommended as part of primary cervical screening for women younger than 30 years. HPV testing is recommended for women of any age as a triage test with atypical squamous cells of undetermined significance (ASC-US) results and as an option for follow-up of women with HPV-positive ASC-US, atypical squamous cells "cannot rule out high-grade", low-grade squamous intraepithelial lesions, or atypical granular cells not found to have CIN 2/3. HPV testing is also recommended as an alternative to colposcopy and/or cytology for follow-up of treated cases. Proper use of HPV testing improves the management of women with cytologic abnormalities.

摘要

人乳头瘤病毒(HPV)感染是宫颈癌的主要病因。因此,HPV检测可使宫颈筛查及宫颈细胞学异常管理的临床获益最大化。30岁及以上女性HPV检测结果为阴性且巴氏试验结果正常,可安全地将宫颈筛查间隔延长至3年。然而,由于HPV感染在年轻女性中很常见且通常是短暂的,不建议将HPV检测作为30岁以下女性初次宫颈筛查的一部分。对于任何年龄的女性,若其非典型鳞状细胞意义不明确(ASC-US)检测结果为阳性,建议进行HPV检测以作分流检查,对于HPV阳性的ASC-US、非典型鳞状细胞“不能排除高级别病变”、低级别鳞状上皮内病变或未发现CIN 2/3的非典型颗粒细胞的女性,HPV检测也可作为随访的一种选择。对于治疗后的病例随访,也建议将HPV检测作为阴道镜检查和/或细胞学检查的替代方法。正确使用HPV检测可改善对细胞学异常女性的管理。

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