Wang Guo-Ping, Li Rui-Zhen, Wu Lan-Na, Li Juan, Liu Zhi-Hong, Wang Chun, Zhou Yan-Qiu, Weng Lei-Ming, Wu Rui-Fang
Department of Obstetrics and Gynecologics of Peking University Shenzhen Hospital, Shenzhen, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Jun;30(6):626-30.
To evaluate the value of cervical cytology and hybrid capture II (HC- II) human papillomavarus (HPV) test for screening cervical lesion.
Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC- II human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap> or =atypical squamous cells of undetermined sign (ASCUS) or LCT> or =ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-II HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer.
(1) In this study, 7 women had cervical intraepithelial neoplasia (CIN) II, another 7 had CIN III, 1 had cervical cancer in the community; 9 had CIN II, 11 had CIN III, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-II HPV and cytology-HPV parallel test for detecting > or =CIN II was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test.
It was suggested that the first choice for screening of cervical serious lesion were HC-II HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.
评估宫颈细胞学检查及杂交捕获二代(HC-II)人乳头瘤病毒(HPV)检测在筛查宫颈病变中的价值。
2007年12月至2008年3月,对深圳市福田区上梅林社区425名妇女进行改良取样的传统巴氏涂片、液基细胞学检测(LCT)及HC-II人乳头瘤病毒检测,同时对北京大学深圳医院75名妇女进行上述检测。采用年龄分层抽样。巴氏涂片样本用扫帚型取样装置(用于LCT的取样器)采用分流取样法采集。HPV阳性、巴氏涂片≥意义不明确的非典型鳞状细胞(ASCUS)或LCT≥ASCUS的妇女在阴道镜下接受多点活检及宫颈管刮术。最终诊断也取决于病理结果,以评估巴氏涂片、LCT、HC-II HPV、巴氏涂片-HPV联合检测、LCT-HPV联合检测、巴氏涂片-HPV序贯检测及LCT-HPV序贯检测在宫颈癌筛查方案中的价值。
(1)本研究中,社区有7名妇女患有宫颈上皮内瘤变(CIN)II级,另7名患有CIN III级,1名患有宫颈癌;医院分别有9名患有CIN II级,11名患有CIN III级,3名患有宫颈癌。(2)HC-II HPV及细胞学-HPV联合检测对检测≥CIN II的敏感性>95.0%,而阴性预测值接近100.0%。(3)改良取样的巴氏涂片与LCT在筛查有效性及不满意率方面无显著差异。(4)巴氏涂片-HPV联合检测的成本效益比高于LCT-HPV联合检测。
建议筛查宫颈严重病变的首选方法是HC-II HPV及细胞学-HPV联合检测,而巴氏涂片-HPV联合检测是最佳筛查方法。