Department of Pathology, Duke University Medical Center, Durham, NC.
Department of Pathology and Laboratory, School of Medicine, University of North Carolina at Chapel Hill.
Am J Clin Pathol. 2018 Mar 29;149(5):425-433. doi: 10.1093/ajcp/aqy011.
To determine if concomitant high-risk human papillomavirus (HPV-HR) reflex testing may bias the cytologic interpretation of Papanicolaou (Pap) tests.
Percentage of atypical squamous cells of undetermined significance (ASCUS) and HPV-HR positivity was compared between Pap tests with HPV-HR cotesting and HPV-HR reflex testing for ASCUS, with subset analysis of cytopathologists' experience.
ASCUS in the reflex group (41.5%) was significantly higher than the cotesting group (33.0%) (P = .02). There was no difference in HPV-HR positivity or ASCUS/squamous intraepithelial lesion (SIL) ratios between the two groups. The cytopathologists' experience inversely correlated with the proportion of ASCUS but did not explain the higher reflex group ASCUS.
HPV-HR reflex testing may introduce bias in cytologic diagnosis, making it more likely that an ASCUS diagnosis is rendered. HPV-HR and ASCUS/SIL ratios were similar between the groups, so cytopathologist performance was not significantly affected. There was no effect of cytopathologists' experience.
确定高危型人乳头瘤病毒（HPV-HR）同时检测是否会影响巴氏涂片（Pap）检测的细胞学解释。
比较 HPV-HR 联合检测和 HPV-HR 对 ASCUS 进行反射检测时的不典型鳞状细胞意义不明确（ASCUS）和 HPV-HR 阳性率，并对细胞病理学家的经验进行亚组分析。
反射组的 ASCUS（41.5%）明显高于联合检测组（33.0%）（P=0.02）。两组 HPV-HR 阳性率或 ASCUS/鳞状上皮内病变（SIL）比值均无差异。细胞病理学家的经验与 ASCUS 的比例呈负相关，但不能解释反射组 ASCUS 更高的原因。
HPV-HR 反射检测可能会对细胞学诊断产生偏差，使 ASCUS 诊断更有可能做出。两组 HPV-HR 和 ASCUS/SIL 比值相似，因此细胞病理学家的表现没有受到显著影响。细胞病理学家的经验没有影响。
