通过常规细胞学和 HPV 联合检测中应用液基细胞学成像技术提高宫颈癌和癌前病变的检出率。
Enhanced Detection of Cervical Cancer and Precancer Through Use of Imaged Liquid-Based Cytology in Routine Cytology and HPV Cotesting.
机构信息
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Faculty of Computer Science, Bialystok University of Technology, Bialystok, Poland.
出版信息
Am J Clin Pathol. 2018 Oct 1;150(5):385-392. doi: 10.1093/ajcp/aqy114.
OBJECTIVES
Cervical screening strives to prevent cervical cancer (CxCa), minimizing morbidity and mortality. Most large US reports on cytology and human papillomavirus (HPV) cotesting of women aged 30 years and older are from one laboratory, which used conventional Papanicolaou (Pap) smears from 2003 to 2009.
METHODS
We quantified detection of CxCa and precancer (cervical intraepithelial neoplasia 3/adenocarcinoma in situ [CIN3/AIS]) in 300,800 cotests at Magee Womens Hospital since 2005. Screening histories preceding CxCa and CIN3/AIS diagnoses were examined to assess the contribution of cytology and HPV testing. Cotesting utilized Food and Drug Administration-approved imaged liquid-based cytology (LBC) and from-the-vial HPV tests.
RESULTS
LBC identified more women subsequently diagnosed with CxCa and CIN3/AIS than HPV testing. HPV-negative/cytology-positive results preceded 13.1% of CxCa and 7.2% of CIN3/AIS diagnoses.
CONCLUSIONS
LBC enhanced cotesting detection of CxCa and CIN3/AIS to a greater extent than previously reported with conventional Pap smear and HPV cotesting.
目的
宫颈筛查旨在预防宫颈癌（CxCa），最大程度地降低发病率和死亡率。大多数美国关于 30 岁及以上女性细胞学和人乳头瘤病毒（HPV）联合检测的大型报告均来自一个实验室，该实验室在 2003 年至 2009 年期间使用传统巴氏涂片。
方法
自 2005 年以来，我们在 Magee 妇女医院对 300800 次联合检测进行了定量检测，以评估细胞学和 HPV 检测在宫颈癌前病变（宫颈上皮内瘤变 3/原位腺癌 [CIN3/AIS]）和宫颈癌（CxCa）中的作用。在 CxCa 和 CIN3/AIS 诊断之前，对筛查史进行了检查，以评估细胞学和 HPV 检测的贡献。联合检测采用了美国食品和药物管理局批准的基于液基的成像细胞学（LBC）和即用型 HPV 检测。
结果
LBC 比 HPV 检测识别出更多随后被诊断为 CxCa 和 CIN3/AIS 的女性。HPV 阴性/细胞学阳性结果是 CxCa 和 CIN3/AIS 诊断的 13.1%和 7.2%的原因。
结论
LBC 比以前报道的使用传统巴氏涂片和 HPV 联合检测在宫颈癌和 CIN3/AIS 的联合检测中更能提高 CxCa 和 CIN3/AIS 的检出率。
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