HIV 感染妇女的巴氏涂片检查和宫颈组织学检查均轻度异常。

Minimally abnormal Pap testing and cervical histology in HIV-infected women.

机构信息

Department of Obstetrics and Gynecology, Boston University Medical Campus, Boston, MA 02118, USA.

出版信息

J Womens Health (Larchmt). 2012 Jan;21(1):87-91. doi: 10.1089/jwh.2010.2562. Epub 2011 Oct 19.

DOI:10.1089/jwh.2010.2562

PMID:22011239

Abstract

OBJECTIVE

To assess the underlying histology of HIV-infected women with minimally abnormal Pap tests compared to HIV-uninfected women by evaluating their colposcopic and histologic outcomes.

METHODS

Retrospective analysis was performed to identify HIV-infected women who had at least one cervical Pap test from 2002 through 2008 at Boston Medical Center. We identified women who underwent colposcopy within 6 months of a minimally abnormal Pap test (atypical squamous cells of undetermined significance with positive high-risk human papillomavirus testing [ASCUS/HPV+] or low-grade squamous intraepithelial lesion (LSIL)). Our outcome was the proportion of HIV-infected women with histologic cervical intraepithelial neoplasia 2 or worse (CIN2+). We then compared these outcomes to those of a cohort of HIV-uninfected women from the same institution.

RESULTS

There were 655 HIV-infected women who had Pap testing in the study time frame, and 146 (22%) had a minimally abnormal Pap test (ASCUS/HPV+ or LSIL). Of the 90 HIV-infected women who had subsequent colposcopy within 6 months, colposcopy was negative for 20 (22%), CIN1 for 41 (46%), and CIN2+ for the remaining 29 (32%). During the same time period, there were 747 HIV-uninfected women who underwent colposcopy within 6 months of a minimally abnormal Pap test. Colposcopy was negative for 336 (45%), CIN1 for 254 (34%), and CIN2+ for 157 (21%). After adjusting for differences in age and race, the HIV-infected women were more likely to have CIN2+ after a minimally abnormal Pap test (p=0.002) (adjusted odds ratio [OR] 2.17, 95% confidence interval [CI] 1.33-3.62). There were no diagnosed cases of cervical cancer.

CONCLUSIONS

HIV-infected women have higher rates of underlying CIN2+ for minimally abnormal Pap tests compared with HIV-uninfected women.

摘要

目的

通过评估 HIV 感染女性的阴道镜和组织学结果，来评估与 HIV 未感染女性相比，HIV 感染女性巴氏涂片检查结果轻微异常的潜在组织学。

方法

对 2002 年至 2008 年间在波士顿医疗中心接受过至少一次巴氏涂片检查的 HIV 感染女性进行回顾性分析。我们确定了在巴氏涂片检查结果轻微异常（非典型鳞状细胞不能明确意义，高危型人乳头瘤病毒检测阳性[ASCUS/HPV+]或低度鳞状上皮内病变[LSIL]）后 6 个月内行阴道镜检查的女性。我们的研究结果是组织学宫颈上皮内瘤变 2 级或更高级别（CIN2+）的 HIV 感染女性比例。然后，我们将这些结果与来自同一机构的一组 HIV 未感染女性进行比较。

结果

在研究期间，共有 655 名 HIV 感染女性进行了巴氏涂片检查，其中 146 名（22%）巴氏涂片检查结果轻微异常（ASCUS/HPV+或 LSIL）。在随后的 6 个月内，有 90 名 HIV 感染女性行阴道镜检查，其中 20 名（22%）阴道镜检查结果阴性，41 名（46%）CIN1 级，其余 29 名（32%）CIN2+。在同一时期，有 747 名 HIV 未感染女性在巴氏涂片检查结果轻微异常后 6 个月内行阴道镜检查。阴道镜检查结果阴性的有 336 名（45%），CIN1 级的有 254 名（34%），CIN2+的有 157 名（21%）。调整年龄和种族差异后，HIV 感染女性巴氏涂片检查结果轻微异常后发生 CIN2+的可能性更高（p=0.002）（调整后比值比[OR] 2.17，95%置信区间[CI] 1.33-3.62）。没有诊断为宫颈癌的病例。