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高危型人乳头瘤病毒 DNA 检测:在低级别宫颈病变分流中是否有用?5 年随访。

High-risk human papillomavirus DNA test: could it be useful in low-grade cervical lesion triage? Five-year follow-up.

机构信息

1Department of Woman and Child Health, University of Padua, Padua, Italy.

出版信息

Reprod Sci. 2014 Feb;21(2):198-203. doi: 10.1177/1933719113492214. Epub 2013 Jun 6.

Abstract

We conducted a retrospective, observational study in order to evaluate the role of high-risk human papillomavirus (hrHPV)-DNA test in patients with first diagnosis of low-grade squamous intraepithelial lesions (L-SILs).Patients were divided into group A, annual Papanicolaou test and hrHPV-DNA tests (167 patients) and group B, immediate colposcopy, followed by annual papanicolaou test and hrHPV-DNA tests (164 patients). We assessed sensitivity, specificity, negative predictive value (NPV), positive predictive value, positive-negative likelihood ratio of hrHPV-DNA test, and 5-year relative risk of cervical intraepithelial neoplasia grade 2 in hrHPV-DNA+. Colposcopy is still considered the best choice for women with L-SIL and hrHPV-DNA+ test. High sensitivity and NPV of hrHPV-DNA test permit to use it in the follow-up of L-SIL with a HPV-negative status, without necessity of referring to colposcopy.

摘要

我们进行了一项回顾性观察研究,旨在评估高危型人乳头瘤病毒(hrHPV)-DNA 检测在初次诊断为低度鳞状上皮内病变(L-SIL)患者中的作用。患者分为 A 组,每年进行巴氏涂片检查和 hrHPV-DNA 检测(167 例)和 B 组,立即行阴道镜检查,然后每年进行巴氏涂片检查和 hrHPV-DNA 检测(164 例)。我们评估了 hrHPV-DNA 检测的敏感性、特异性、阴性预测值(NPV)、阳性预测值、hrHPV-DNA 检测的阳性-阴性似然比,以及 hrHPV-DNA+患者的 5 年宫颈上皮内瘤变 2 级的相对风险。阴道镜检查仍被认为是 L-SIL 和 hrHPV-DNA+检测患者的最佳选择。hrHPV-DNA 检测的高敏感性和 NPV 允许在 HPV 阴性的情况下对 L-SIL 进行随访,无需转诊行阴道镜检查。

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