Department of Gynecology and Obstetrics, CHU Nîmes, Nîmes, France.
Department of Gynecology and Obstetrics, CHU Montpellier, Montpellier, France; Laboratory of Biostatistics, Epidemiology and Clinical Research, EA2415, University of Montpellier, Montpellier, France.
J Clin Virol. 2018 Nov;108:12-18. doi: 10.1016/j.jcv.2018.08.010. Epub 2018 Aug 31.
With population ageing, post-menopausal women represent a new group to be considered in cervical cancer screening strategies, including the significance of High Risk (HR)-HPV detection.
A retrospective analysis was conducted in a cohort of 406 menopausal women attending routine gynaecological consultation at the Hospital of Montpellier (France).
All women benefited from a cervical smear and HR-HPV detection using Hybrid Capture 2 (HC2) test. The prevalence of cytological abnormalities, HR-HPV detection and risk factors associated with HR-HPV detection were analyzed. Evolution of both tests was evaluated in a sub-group of women with adequate follow-up.
Five women (1.2%) had an abnormal cervical smear at baseline. HR-HPV was detected in 40 women (9.9%), including 36 women with normal cytology (9%). Risk factors associated with HR-HPV detection at enrolment were a previous history of Cervical Intraepithelial Neoplasia and a high socio-economic level, but not hormone replacement therapy. When cytology and HR-HPV detection were negative at enrolment, both remained negative for 95% (230/241) of women during follow-up (median duration of follow-up: 60 months). HR-HPV persistence was observed for 55% (18/33) of women with normal cytology and positive HR-HPV test. Finally, all women with a final diagnosis of high-grade (CIN2+) cervical lesion (N = 7) had a positive HR-HPV test with or without abnormal cytology.
HR-HPV was detected in 9.9% of menopausal women. HR-HPV detection was a better predictor of CIN2+ lesions than cytology in this population. Women with previous CIN history should benefit from HR-HPV testing and need long term follow-up.
随着人口老龄化，绝经后妇女成为宫颈癌筛查策略中需要考虑的新群体，包括高危型（HR）-HPV 检测的意义。
对在法国蒙彼利埃医院接受常规妇科咨询的 406 名绝经后妇女进行了一项回顾性分析。
所有女性均接受宫颈涂片检查和 HR-HPV 检测，采用杂交捕获 2（HC2）检测。分析了细胞学异常、HR-HPV 检测的发生率以及与 HR-HPV 检测相关的危险因素。在具有足够随访的女性亚组中评估了这两种检测的变化。
基线时，有 5 名（1.2%）女性的宫颈涂片异常。在 40 名（9.9%）女性中检测到 HR-HPV，其中 36 名（9%）的细胞学正常。纳入时与 HR-HPV 检测相关的危险因素包括既往宫颈上皮内瘤变史和较高的社会经济水平，但与激素替代治疗无关。当纳入时的细胞学和 HR-HPV 检测均为阴性时，241 名（95%）女性在随访期间（中位随访时间：60 个月）仍均为阴性。在细胞学正常且 HR-HPV 检测阳性的 33 名女性中，有 55%（18/33）的 HR-HPV 持续存在。最后，所有最终诊断为高级别（CIN2+）宫颈病变的女性（N=7）的 HR-HPV 检测均为阳性，无论细胞学是否异常。
在绝经后妇女中，HR-HPV 的检出率为 9.9%。在该人群中，HR-HPV 检测比细胞学更能预测 CIN2+病变。有既往 CIN 史的女性应受益于 HR-HPV 检测，并需要长期随访。
