Department of Pathology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Am J Clin Pathol. 2012 Mar;137(3):437-43. doi: 10.1309/AJCP9TO1OMXLDDPI.
Current American Society of Colposcopy and Cervical Pathology recommendations about human papillomavirus (HPV) triage and further management for atypical squamous cells are pertinent to cervical Papanicolaou (Pap) tests. There are limited data on HPV detection in vaginal liquid-based cytology (LBC) specimens. The aims of this study were to determine whether adjunctive high-risk (HR)-HPV testing is useful for disease risk assessment in women with vaginal atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells, cannot exclude HSIL (ASC-H) Pap results. We identified 1,125 ASC-US and 36 ASC-H vaginal Pap results with HR-HPV testing. Of the cases, 244 (21.7%) ASC-US and 21 (58%) ASC-H were HR-HPV+. Among ASC-US HR-HPV+ cases, 47.8% had a squamous intraepithelial lesion (SIL) compared with 4.7% of HR-HPV- cases. Among ASC-H HR-HPV+ cases, 75% (12/16) had SIL compared with 31% (4/13) in HR-HPV- cases. Our results indicate that HPV triage testing is a reasonable and cost-effective approach for women with ASC-US vaginal Pap results and also a useful option for women with ASC-H vaginal Pap results.
当前，美国阴道镜和宫颈病理学会关于人乳头瘤病毒（HPV）的分流和进一步管理的建议与宫颈巴氏涂片检查相关。关于阴道液基细胞学（LBC）标本中 HPV 检测的资料有限。本研究的目的是确定在阴道非典型鳞状细胞意义不明确（ASC-US）和非典型鳞状细胞、不能排除高级别鳞状上皮内病变（ASC-H）巴氏涂片结果的女性中，辅助高危型（HR）-HPV 检测是否有助于疾病风险评估。我们确定了 1125 例 ASC-US 和 36 例 ASC-H 阴道巴氏涂片结果，同时进行了 HR-HPV 检测。在这些病例中，244 例（21.7%）ASC-US 和 21 例（58%）ASC-H 为 HR-HPV+。在 ASC-US HR-HPV+病例中，47.8%有鳞状上皮内病变（SIL），而 HR-HPV-病例中这一比例为 4.7%。在 ASC-H HR-HPV+病例中，75%（12/16）有 SIL，而 HR-HPV-病例中这一比例为 31%（4/13）。我们的结果表明，HPV 分流检测是 ASC-US 阴道巴氏涂片结果女性的一种合理且具有成本效益的方法，也是 ASC-H 阴道巴氏涂片结果女性的有用选择。
