Departments of *Pathology and †Obstetrics and Gynecology, London Health Sciences Centre and the University of Western Ontario, and the ‡Middlesex-London Health Unit, London, Ontario, Canada.
J Low Genit Tract Dis. 2000 Jan;4(1):12-7. doi: 10.1046/j.1526-0976.2000.41003.x.
We set out to evaluate Hybrid Capture (Digene Corporation, Silver Spring, MD) testing for human papillomavirus (HPV) in the management of a screening population with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LGSIL).
A total of 619 patients with ASCUS or LGSIL Papanicolaou smears were tested for high-risk HPV types. They then were followed at 6-month intervals with Papanicolaou smears and repeat HPV testing. Patients with persistent or progressive disease were referred for colposcopy. HPV results were compared to the most significant follow-up cytological or colposcopic diagnosis to determine whether Hybrid Capture HPV testing was predictive of outcome. A cost analysis was performed.
Follow-up of 12 to 30 months was available for 471 patients (76.1%). Outcome diagnoses for 190 patients who initially tested HPV-positive were as follows: 49% benign, 14% ASCUS, 19% LGSIL, 18% HGSIL, and 0.5% cancer. For 281 patients who initially tested HPV-negative, outcomes were 77% benign, 14% ASCUS, 6% LGSIL, 2% HGSIL, and 0.3% cancer. Twenty-six of the patients with HGSIL had two or more HPV tests, and all these patients had at least one positive result.
Hybrid Capture testing for high-risk HPV types was predictive of which patients presenting with ASCUS/LGSIL would persist or progress to HGSIL (p < .001). The cost of adding Hybrid Capture testing was intermediate between the cost of cytological follow-up and referral of all patients with ASCUS/LGSIL to colposcopy.
我们旨在评估杂交捕获（Digene 公司，马里兰州银泉）检测人乳头瘤病毒（HPV）在不典型鳞状细胞意义不明确（ASCUS）或低级别鳞状上皮内病变（LGSIL）筛查人群中的管理效果。
共有 619 例 ASCUS 或 LGSIL 巴氏涂片患者进行高危 HPV 型检测。然后，他们以 6 个月的间隔用巴氏涂片和重复 HPV 检测进行随访。患有持续性或进行性疾病的患者被转诊行阴道镜检查。HPV 结果与最显著的随访细胞学或阴道镜检查诊断进行比较，以确定杂交捕获 HPV 检测是否可预测结局。进行了成本分析。
471 例患者（76.1%）可获得 12 至 30 个月的随访。190 例 HPV 检测阳性的初始患者的结局诊断如下：49%良性、14%ASCUS、19%LGSIL、18%HSIL 和 0.5%癌症。281 例 HPV 检测阴性的初始患者的结局为：77%良性、14%ASCUS、6%LGSIL、2%HSIL 和 0.3%癌症。26 例 HSIL 患者进行了两次或更多次 HPV 检测，所有这些患者均至少有一次阳性结果。
高危 HPV 型杂交捕获检测可预测哪些 ASCUS/LGSIL 患者会持续存在或进展为 HSIL（p<0.001）。添加杂交捕获检测的成本在细胞学随访的成本和将所有 ASCUS/LGSIL 患者转诊行阴道镜检查的成本之间。
