Zheng Baowen, Li Zaibo, Griffith Christopher C, Yan Shanshan, Chen Congde, Ding Xiangdong, Liang Xiaoman, Yang Huaitao, Zhao Chengquan
Guangzhou KingMed Diagnostics, Guangzhou, People's Republic of China.
Department of Pathology, Wexner Medical Center, Ohio State University, Columbus, Ohio.
Cancer Cytopathol. 2015 Jul;123(7):428-34. doi: 10.1002/cncy.21557. Epub 2015 May 8.
Cervical cancer and its precursor lesions are caused by a persistent high-risk human papillomavirus (hrHPV) infection. hrHPV testing has been reported to have higher sensitivity than Papanicolaou (Pap) testing for the detection of cervical precursor lesions. However, limited data are available for prior human papillomavirus (HPV) testing results for patients later diagnosed with invasive cervical cancer, especially in countries lacking a national cervical cancer screening program such as China. This study investigated prior hrHPV testing results for patients with invasive cervical cancer in China.
Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from Guangzhou KingMed Diagnostics (the largest independent pathology laboratory in China); prior hrHPV and Pap test results obtained within the year before the cancer diagnosis were recorded.
HPV testing was negative in 7.5% of 427 cases of invasive cervical carcinoma, including squamous cell carcinoma (5%) and adenocarcinoma (25%). In 155 cervical cancer cases with prior hrHPV and Pap testing, the negative rate for Pap testing was 1.9%, and the negative rate for HPV was 9.7%. Furthermore, when only cases of adenocarcinoma (n = 18) were examined, both the hrHPV-negative rate and the Pap-negative rate were higher at 33% and 5.6%, respectively.
These data demonstrate a considerable prior hrHPV-negative rate and a lower prior Pap-negative rate in patients with invasive cervical carcinoma (especially adenocarcinoma) from a population of women without access to an established screening program.
宫颈癌及其前驱病变是由持续性高危型人乳头瘤病毒（hrHPV）感染引起的。据报道，hrHPV检测在检测宫颈前驱病变方面比巴氏（Pap）检测具有更高的灵敏度。然而，对于后来被诊断为浸润性宫颈癌的患者，先前的人乳头瘤病毒（HPV）检测结果的数据有限，尤其是在像中国这样缺乏国家宫颈癌筛查计划的国家。本研究调查了中国浸润性宫颈癌患者先前的hrHPV检测结果。
从广州金域医学检验中心（中国最大的独立病理实验室）检索组织学诊断为浸润性宫颈癌的病例；记录癌症诊断前一年内获得的先前hrHPV和Pap检测结果。
427例浸润性宫颈癌病例中，7.5%的病例HPV检测为阴性，其中包括鳞状细胞癌（5%）和腺癌（25%）。在155例有先前hrHPV和Pap检测的宫颈癌病例中，Pap检测的阴性率为1.9%，HPV检测的阴性率为9.7%。此外，仅检查腺癌病例（n = 18）时，hrHPV阴性率和Pap阴性率更高，分别为33%和5.6%。
这些数据表明，在无法获得既定筛查计划的女性人群中，浸润性宫颈癌（尤其是腺癌）患者先前的hrHPV阴性率相当高，而先前的Pap阴性率较低。
