Nowakowski Andrzej, de Souza Sabrina Collas, Jach Robert, Rosillon Dominique, Książek Alicja, Holl Katsiaryna
Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, ul. Staszica 16, 20-081, Lublin, Poland,
Pathol Oncol Res. 2015 Jul;21(3):703-11. doi: 10.1007/s12253-014-9877-4. Epub 2014 Dec 30.
This study was performed to assess attribution of high grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) to human papillomavirus (HPV) genotypes and secondarily to assess reproducibility of HG-CIN/ICC diagnosis obtained in Poland. Formaldehyde fixed, paraffin embedded blocks of HG-CIN/ICC from two distant institutions were sent to a central laboratory together with original histological diagnoses. Central/expert review of histopathological specimens was performed and agreement between local and central/expert diagnoses was calculated. HPV detection and genotyping in the samples was carried out with the use of SPF10-LiPA25 technology. Results were analyzed for 205 HG-CIN and 193 ICC cases with centrally confirmed diagnoses. Kappa coefficients and 95 % confidence intervals for HG-CIN and ICC diagnoses were: 0.13 (0.09;0.17) and 0.19 (0.11;0.26) respectively. Cohen's kappa coefficients for lesions with representative number of samples ranged from 0.01 for cervical intraepithelial neoplasia grade 2 to 0.75 for adenocarcinoma. HPV DNA was detected in 96.1 and 91.2 % of the confirmed HG-CIN and ICC specimens respectively. HPV positive HG-CIN was most commonly attributed to HPV types: 16 (62.8), 33 (7.8), 31 (6.6), 52 (3.7), 45 (2.6) and 58 (2.6 %). HPV positive ICC was most commonly attributed to HPV types: 16 (72.1), 18 (10.8), 33 (5.7), 45 (3.4) and 31 (1.7 %). Reproducibility of histological diagnosis of HG-CIN/ICC obtained in Poland generally increases with the severity of lesion and is lowest for cervical intraepithelial neoplasia grade 2 and highest for adenocarcinoma. Over 80 % of ICC cases are vaccine-preventable in Poland.
本研究旨在评估高级别宫颈上皮内瘤变（HG-CIN）和浸润性宫颈癌（ICC）与人乳头瘤病毒（HPV）基因型的相关性，并其次评估在波兰获得的HG-CIN/ICC诊断的可重复性。来自两个不同机构的HG-CIN/ICC甲醛固定、石蜡包埋块与原始组织学诊断一起被送至中央实验室。对组织病理学标本进行中央/专家审查，并计算局部与中央/专家诊断之间的一致性。使用SPF10-LiPA25技术对样本进行HPV检测和基因分型。对205例经中央确诊的HG-CIN和193例ICC病例的结果进行了分析。HG-CIN和ICC诊断的Kappa系数及95%置信区间分别为：0.13（0.09；0.17）和0.19（0.11；0.26）。具有代表性样本数量的病变的Cohen's kappa系数范围从宫颈上皮内瘤变2级的0.01到腺癌的0.75。分别在96.1%和91.2%经确诊的HG-CIN和ICC标本中检测到HPV DNA。HPV阳性的HG-CIN最常见的归因于HPV类型：16型（62.8%）、33型（7.8%）、31型（6.6%）、52型（3.7%）、45型（2.6%）和58型（2.6%）。HPV阳性的ICC最常见的归因于HPV类型：16型（72.1%）、18型（10.8%）、33型（5.7%）、45型（3.4%）和31型（1.7%）。在波兰获得的HG-CIN/ICC组织学诊断的可重复性通常随病变严重程度增加，在宫颈上皮内瘤变2级时最低，在腺癌时最高。在波兰，超过80%的ICC病例是可通过疫苗预防的。
