Pierce Kirsten J, Currens Heather S, Tafe Laura J, Tsongalis Gregory J, Padmanabhan Vijayalakshmi
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Diagn Cytopathol. 2016 Apr;44(4):280-2. doi: 10.1002/dc.23436. Epub 2016 Jan 23.
HPV is known to have a predilection for infecting the transformation zone (TZ). Endocervical cells (EC) on a Pap test (PT) indicate that the cervical TZ has been sampled. Earlier repeat testing of women lacking EC is of little value in further detecting disease, thus a sample without EC is not necessarily inadequate. Both HPV testing and PT can be performed using a single sample; however, few studies have investigated the relationship between HPV results and TZ sampling.
Specimens were collected following the ThinPrep(®) liquid-based PT protocol. The Roche Cobas(®) HPV test was performed on post-aliquot samples. Data was collected retrospectively on 500 patients: 250 consecutive cases of EC- and 250 of EC+ on PT. To maintain uniformity, we included only cases diagnosed as negative (NILM). We compared HPV test results within each category. As a positive control, five consecutive cases each of LSIL and HSIL were also reviewed.
Of NILM cases, 11 of 250 EC+ cases and 14 of 250 EC- cases were positive for hrHPV. HPV 16 was present in 5 of 11 EC + cases and in 1 of 14 EC- cases. Of LSIL cases, 1 of 5 EC+ cases was positive for hrHPV, and 2 of 5 EC- cases were positive for hrHPV. Of HSIL cases, 5 of 5 EC+ cases were hrHPV+. In the time period studied, only one case of EC- HSIL was found, which was positive for hrHPV.
Although our study did not prove a significant correlation between HPV testing results and EC on PT, more EC+ PTs were positive for HPV16 compared to EC- PTs. The absence of EC on PT does not appear to warrant re-testing for HPV infection, though larger studies are required to determine the significance of low HPV 16 in PT without EC. Diagn. Cytopathol. 2016;44:280-282. © 2016 Wiley Periodicals, Inc.
已知人乳头瘤病毒（HPV）倾向于感染转化区（TZ）。巴氏试验（PT）中的宫颈管内细胞（EC）表明已对宫颈转化区进行了采样。对于缺乏EC的女性进行早期重复检测对进一步检测疾病的价值不大，因此没有EC的样本不一定不充分。HPV检测和PT都可以使用单个样本进行；然而，很少有研究调查HPV检测结果与转化区采样之间的关系。
按照ThinPrep（®）液基PT方案收集标本。在等分后的样本上进行罗氏Cobas（®）HPV检测。回顾性收集了500例患者的数据：PT检查中连续250例EC阳性和250例EC阴性。为保持一致性，我们仅纳入诊断为阴性（未见上皮内病变或恶性病变，NILM）的病例。我们比较了每个类别中的HPV检测结果。作为阳性对照，还回顾了5例连续的低度鳞状上皮内病变（LSIL）和高度鳞状上皮内病变（HSIL）病例。
在NILM病例中，250例EC阳性病例中有11例、250例EC阴性病例中有14例高危型HPV（hrHPV）检测呈阳性。HPV 16存在于11例EC阳性病例中的5例以及14例EC阴性病例中的1例。在LSIL病例中，5例EC阳性病例中有1例hrHPV检测呈阳性，5例EC阴性病例中有2例hrHPV检测呈阳性。在HSIL病例中，5例EC阳性病例均为hrHPV阳性。在所研究的时间段内，仅发现1例EC阴性的HSIL病例，其hrHPV检测呈阳性。
尽管我们的研究未证明HPV检测结果与PT中的EC之间存在显著相关性，但与EC阴性的PT相比，EC阳性的PT中HPV16阳性的情况更多。PT中没有EC似乎并不需要重新检测HPV感染，不过需要更大规模的研究来确定PT中HPV 16低度阳性的意义。诊断细胞病理学。2016；44：280 - 282。©2016威利期刊公司。
