Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Arch Pathol Lab Med. 2011 Dec;135(12):1545-9. doi: 10.5858/arpa.2010-0658-OA.
Data on high-risk human papillomavirus (hrHPV) DNA test results in vaginal, liquid-based cytology (LBC) specimens and corresponding cytologic and histopathologic correlation data are limited.
To analyze follow-up correlation data associated with vaginal (after hysterectomy) low-grade squamous intraepithelial lesion (LSIL) LBC and hrHPV test results.
Hospital records were searched for vaginal LSIL LBC and hrHPV results between July 1, 2005, and July 30, 2009. Histopathologic and Papanicolaou test follow-up correlation data were analyzed.
During the study period, 2892 patients with test results from both posthysterectomy vaginal LBC and hrHPV were identified: 148 (5.1%) of the patients had vaginal Papanicolaou test results reported as LSIL, with hrHPV detected in 113 of the 148 patients (76.4%). Of 148 patients, 59 of those with vaginal LSIL including 48 (81.4%) with positive HPV testing and 11 (18.6%) with negative HPV testing results had a follow-up vaginal biopsy. Histopathologic vaginal intraepithelial neoplasia (VAIN) 2/3 was diagnosed in 7 of 59 patients (11.9%) with biopsies. In all 7 patients who were diagnosed with VAIN 2/3, hrHPV was detected in the LBC vial. No VAIN 2/3 diagnoses were documented in the biopsy specimens from the 11 patients with hrHPV(-) LSIL Papanicolaou test results. Histopathologic VAIN 2/3 was diagnosed from vaginal biopsies in 7 of the 48 patients (14.6%) with vaginal hrHPV(+) LSIL test results.
Sensitivity and specificity of hrHPV test results associated with histopathologic follow-up diagnoses of VAIN 2/3 in patients with vaginal LSIL results were 100% and 21.2%, respectively. The positive predictive value of a vaginal hrHPV(+) LSIL result for a subsequent histopathologic VAIN 2/3 diagnosis was 14.6%. No cases of VAIN 2/3 were diagnosed in the 11 patients with vaginal hrHPV(-) LSIL results. Correlations of vaginal cytologic, histopathologic, and human papillomavirus findings were quite similar to correlation findings previously reported in older women with cervical LSIL test results.
有关阴道液基细胞学（LBC）标本高危型人乳头瘤病毒（hrHPV）DNA 检测结果及相应细胞学和组织病理学相关性数据较为有限。
分析与阴道（子宫切除术后）低级别鳞状上皮内病变（LSIL）LBC 和 hrHPV 检测结果相关的随访相关性数据。
检索 2005 年 7 月 1 日至 2009 年 7 月 30 日之间子宫切除术后阴道 LSIL LBC 和 hrHPV 检测结果的医院记录。分析组织病理学和巴氏试验随访相关性数据。
在研究期间，共发现 2892 例具有阴道 LBC 和 hrHPV 检测结果的患者：148 例（5.1%）患者的阴道巴氏试验结果报告为 LSIL，其中 113 例（76.4%）患者检测到了 hrHPV。在 148 例患者中，59 例阴道 LSIL 患者（包括 48 例 HPV 检测阳性患者和 11 例 HPV 检测阴性患者）进行了阴道活检。在接受阴道活检的 59 例患者中，诊断为阴道上皮内瘤变（VAIN）2/3 级的有 7 例（11.9%）。所有 7 例诊断为 VAIN 2/3 级的患者，其 LBC 管中均检测到了 hrHPV。在 11 例 HPV 检测阴性的 LSIL 巴氏试验结果患者中，活检标本中未发现 VAIN 2/3 级病变。在 48 例阴道 hrHPV 阳性 LSIL 检测结果患者中，有 7 例患者（14.6%）经阴道活检诊断为 VAIN 2/3 级。
与阴道 LSIL 结果相关的组织病理学随访诊断为 VAIN 2/3 级的患者，hrHPV 检测结果的敏感性和特异性分别为 100%和 21.2%。阴道 hrHPV 阳性 LSIL 结果对随后发生的组织病理学 VAIN 2/3 级诊断的阳性预测值为 14.6%。在 11 例阴道 hrHPV 阴性 LSIL 结果患者中，未诊断出 VAIN 2/3 级病变。阴道细胞学、组织病理学和人乳头瘤病毒检测结果的相关性与之前报道的宫颈 LSIL 检测结果的老年女性相关性非常相似。
