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不同年龄组中宫颈细胞学检查和人乳头瘤病毒高危型DNA检测对低级别和高级别鳞状上皮内病变诊断价值的比较

Comparison of the diagnostic value of cervical cytology and HPV HR DNA testing for the diagnosis of low-grade and high-grade squamous intraepithelial lesions across different age groups.

作者信息

Paluszkiewicz Aleksandra, Pruski Dominik, Iwaniec Kinga, Kędzia Witold

机构信息

Division of Gynecology, Department of Perinatology and Gynecology, Gynecology and Obstetrics Clinical Hospital, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.

出版信息

Ginekol Pol. 2017;88(3):141-146. doi: 10.5603/GP.a2017.0027.

Abstract

OBJECTIVES

To assess the diagnostic value of cervical cytology and HPV HR DNA testing for the diagnosis of low grade and high-grade squamous intraepithelial lesions across different age groups.

MATERIAL AND METHODS

The study included 1103 patients, age 25-70 years. All patients underwent in-depth diagnostic tests following either an abnormal Pap test result or a clinically suspicious cervical lesion. In all women the following examinations were performed: a molecular test detecting 14 high-risk types of HPV, a colposcopy examination, as well as directed-biopsy of the cervix. The studied population was subdivided into four age groups.

RESULTS

It was observed that the percentage of high grade squamous intraepithelial lesions (HSIL) and cancers increased with women's age. Sensitivity of both methods for detecting high-grade squamous intraepithelial lesions was highest for women aged 40-49 years. Sensitivity values of HPV testing was higher than that of cervical cytology among women under age 50.

CONCLUSIONS

Specificity of HPV testing increased significantly with age of women and was several fold higher across all age groups than the specificity of cervical cytology.

摘要

目的

评估宫颈细胞学检查和人乳头瘤病毒(HPV)高危型DNA检测在不同年龄组中诊断低级别和高级别鳞状上皮内病变的诊断价值。

材料与方法

该研究纳入了1103例年龄在25至70岁之间的患者。所有患者在巴氏试验结果异常或宫颈病变临床可疑后均接受了深入的诊断测试。对所有女性进行了以下检查:检测14种高危型HPV的分子检测、阴道镜检查以及宫颈定向活检。研究人群被分为四个年龄组。

结果

观察到高级别鳞状上皮内病变(HSIL)和癌症的百分比随女性年龄增加而升高。两种检测高级别鳞状上皮内病变方法的敏感性在40至49岁女性中最高。50岁以下女性中,HPV检测的敏感性值高于宫颈细胞学检查。

结论

HPV检测的特异性随女性年龄显著增加,且在所有年龄组中均比宫颈细胞学检查的特异性高几倍。

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