American Society for Clinical Pathology Institute, Washington, DC 20005, USA.
Am J Clin Pathol. 2012 Aug;138(2):241-6. doi: 10.1309/AJCPNTK6G2PXWHOO.
Cervical intraepithelial neoplasia grade 3 (CIN 3) is the best proxy in research and screening for invasive cancer risk. Yet the timing of CIN 3 development is uncertain because of measurement errors integral to its diagnosis. We were interested in estimating the proportions of prevalent vs incident CIN 3 within 2 years of finding a minor cytologic abnormality. We estimate that only 17 (2.8%) of 613 CIN 3 cases diagnosed during the 2-year duration of the atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) triage study (ALTS) were incident CIN 3 following an incident human papillomavirus (HPV) infection that persisted until the CIN 3 diagnosis was made. Using prevalent high-grade cytology as a marker of prevalent CIN 3, we estimated that another approximately 23% of CIN 3 cases were incident CIN 3 following a prevalently detected HPV infection that persisted until the CIN 3 diagnosis was made. We concluded that most CIN 3 cases diagnosed within the 2-year time frame were prevalent cases, and most incident CIN 3 cases followed a prevalently detected HPV infection.
宫颈上皮内瘤变 3 级（CIN3）是研究和筛查浸润性癌风险的最佳替代指标。然而，由于其诊断中存在固有测量误差，CIN3 的发展时间尚不确定。我们有兴趣估计在发现轻度细胞学异常后 2 年内发现的 CIN3 的现患率与新发病例率。我们估计，在意义不明确的非典型鳞状细胞（ASCUS）和低级别鳞状上皮内病变（LSIL）分流研究（ALTS）的 2 年期间诊断出的 613 例 CIN3 病例中，只有 17 例（2.8%）是在 HPV 持续感染后发生的新发病例，直到做出 CIN3 诊断。使用现患高级别细胞学作为现患 CIN3 的标志物，我们估计，另外大约 23%的 CIN3 病例是在 HPV 持续感染后发生的新发病例。我们得出结论，在 2 年时间框架内诊断出的大多数 CIN3 病例是现患病例，大多数新发病例 CIN3 病例都有持续存在的 HPV 感染。
