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[宫颈阴道细胞学与尖锐湿疣。再现性和预测价值]

[Cervico-vaginal cytology and condylomata. Reproducibility and predictive value].

作者信息

Dodin-Dewailly S, Brisson J, Roy M, Fortier M, Bouchard C

机构信息

Endocrinologie de la Reproduction, Hôpital Saint-François d'Assise, Quebec, Canada.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1991;20(4):519-24.

PMID:1885887
Abstract

Human Papilloma Virus (HPV) is associated with two groups of intra-epithelial lesions of the cervix: the condyloma or the very low grade lesion, and intra-epithelial cervical neoplasia (CIN) or a higher grade of lesion. Cervico-vaginal cytology can be used to screen for these two types of lesion. Further to this research is to evaluate the reproducibility and the predicted value of cervico-vaginal cytology to detect condylomas. The study is based on 610 patients who were referred because of abnormal cytology. 270 (44%) of these patients were referred because the cytology suggested condylomas and 241 (40%) had cytological signs of CIN. The reference cytology and the control cytology did not accord well. Control cytology showed signs of condyloma in only 116 (43%) of the 270 patients referred for this type of lesion. On the other hand in the case of CIN there was better correlation. Of the 241 patients who were referred for cytological signs of CIN 185 (70%) also had these signs on controlled cytology. The positive predictive value of cytology to diagnose condyloma is relatively poor. In only 126 (47%) of the women referred with diagnosis of condyloma could this diagnosis be confirmed histologically, 20% of these 270 patients had CIN. In contrast the positive predictive value of cytology with signs of CIN were better-182 (76%) of 241 patients who were referred with CIN had the diagnosis confirmed histologically.

摘要

人乳头瘤病毒(HPV)与宫颈的两组上皮内病变相关:尖锐湿疣或极低级别病变,以及宫颈上皮内瘤变(CIN)或更高级别病变。宫颈阴道细胞学检查可用于筛查这两种类型的病变。除此之外,本研究旨在评估宫颈阴道细胞学检查检测尖锐湿疣的可重复性和预测价值。该研究基于610例因细胞学异常而转诊的患者。其中270例(44%)患者因细胞学检查提示尖锐湿疣而转诊,241例(40%)有CIN的细胞学征象。参考细胞学检查和对照细胞学检查结果不太一致。对照细胞学检查显示,在因这类病变转诊的270例患者中,只有116例(43%)有尖锐湿疣征象。另一方面,在CIN病例中相关性较好。在因CIN细胞学征象转诊的241例患者中,185例(70%)在对照细胞学检查中也有这些征象。细胞学检查诊断尖锐湿疣的阳性预测值相对较差。在因诊断为尖锐湿疣而转诊的女性中,只有126例(47%)的诊断能够通过组织学得到证实,这270例患者中有20%患有CIN。相比之下,有CIN征象的细胞学检查阳性预测值较好——在因CIN转诊的241例患者中,182例(76%)的诊断通过组织学得到证实。

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