Huang Lee-Wen, Lin Yu-Hung, Pan Hun-Shan, Seow Kok-Min, Lin Ching-Yu
Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Diagn Cytopathol. 2012 Aug;40(8):673-7. doi: 10.1002/dc.21591. Epub 2011 Mar 25.
High-risk human papillomavirus (HR-HPV) DNA testing has emerged as another testing modality for women with mildly cytologic abnormalities. We conducted a two-year follow-up study of 108 women with mildly abnormal cervical cytology for detection of CIN 2/3. A cervical swab sample was obtained for HPV genotyping by a HPV blot and histologic follow-up results were correlated with HR-HPV types. Of the 108 cases, 93 (86.1%) were positive for HR-HPV DNA. HPV-16 was detected in 45.1% of patients. CIN grade 2 or 3 was confirmed in 25 (23.1%) of the 108 women during the two-year follow-up period. The two-year cumulative incidence rates of CIN 2/3 were 38.6% (17/44) among HPV-16- positive women, but only 5.6% among HR-HPV-positive women without HPV-16 or HPV-18. The sensitivity of a positive HPV-16 test for CIN 2/3 was 68.0%, the specificity was 67.5%. Our results demonstrated that the type-specific HPV-16 test increased sensitivity of detecting high-grade cervical dysplasia for women who have mildly cytologic abnormalities. The implication of the present findings is that HPV genotyping may identify women with the greatest risk of high-grade CIN.
高危型人乳头瘤病毒（HR-HPV）DNA检测已成为针对细胞学轻度异常女性的另一种检测方式。我们对108例宫颈细胞学轻度异常的女性进行了为期两年的随访研究，以检测宫颈上皮内瘤变2/3级（CIN 2/3）。通过HPV印迹法获取宫颈拭子样本进行HPV基因分型，并将组织学随访结果与HR-HPV类型相关联。在这108例病例中，93例（86.1%）HR-HPV DNA检测呈阳性。45.1%的患者检测出HPV-16。在两年的随访期内，108例女性中有25例（23.1%）被确诊为CIN 2级或3级。HPV-16阳性女性中CIN 2/3的两年累积发病率为38.6%（17/44），而在无HPV-16或HPV-18的HR-HPV阳性女性中仅为5.6%。HPV-16检测阳性对CIN 2/3的敏感性为68.0%，特异性为67.5%。我们的结果表明，对于细胞学轻度异常的女性，特定类型的HPV-16检测提高了检测高级别宫颈发育异常的敏感性。本研究结果的意义在于，HPV基因分型可能识别出高级别CIN风险最高的女性。
