Barodawala Shaikhali M, Chadha Kirti, Kavishwar Vikas, Murthy Anuradha, Shetye Shamma
Department of Surgical Pathology & Molecular Biology, Integrated Oncopathology, Metropolis Healthcare Ltd, Mumbai, Maharashtra, India.
Department of Molecular Biology, Metropolis Healthcare Ltd, Mumbai, Maharashtra, India.
Diagn Cytopathol. 2019 May;47(5):374-381. doi: 10.1002/dc.24116. Epub 2018 Nov 23.
Cervical cancer is one of the common cancers in women accounting for 7.9% of all cancers. In India it is the second commonest cancer in women. The immortality of the cancer cell and the relatively long time frame from acquisition of infection to development of cervical cancer was established. As major advancements like LBC, HPV testing were introduced in the recent years, screening has taken a new avatar, the Molecular pap!! The objectives of this study were: To compare gynecologic cytology and abnormal results with respect to conventional and LBC. To study the role of HPV cotesting and ancillary tests performed, that is, HPV CISH, and p16ink4a by IHC.
About 71 924 Conventional and LBC samples were included from August 2009 to December 2017. Cases for HPV testing along the conventional smears were 1539. HPV can be tested from the same LBC vial as the sample remains stable at room temperature for 6 weeks. HPV DNA PCR was carried out in our laboratory for High and Low risk genotypes. Cytology findings were also correlated with histology.
Detection rate of SILs in LBC samples were higher (2.20%). The commonest abnormality was LSIL in LBC and ASCUS in conventional smears. Commonest HR HPV and LR HPV detected was 1 61 856 and 61 142.
LBC with HPV cotesting improves sensitivity and specificity and reduces ambiguous results; allows better compliance, as a negative result of both tests allows patients to get screening every 5 years, thereby increasing screening intervals, important in a resource limited situation.
宫颈癌是女性常见癌症之一，占所有癌症的7.9%。在印度，它是女性中第二常见的癌症。癌细胞的永生以及从感染到宫颈癌发展的相对较长时间框架已得到证实。近年来，随着液基薄层细胞学检测（LBC）、人乳头瘤病毒（HPV）检测等重大进展的引入，筛查呈现出一种新形式——分子巴氏涂片！！本研究的目的是：比较传统涂片和LBC在妇科细胞学及异常结果方面的差异。研究HPV联合检测及辅助检测（即HPV原位杂交（CISH）和免疫组化检测p16ink4a）的作用。
纳入2009年8月至2017年12月期间的约71924份传统涂片和LBC样本。传统涂片进行HPV检测的病例有1539例。HPV可从与LBC相同的样本瓶中检测，因为样本在室温下可稳定保存6周。我们实验室对高危和低危基因型进行了HPV DNA聚合酶链反应（PCR）检测。细胞学检查结果也与组织学结果进行了关联。
LBC样本中高级别鳞状上皮内病变（SILs）的检出率更高（2.20%）。LBC中最常见的异常是低度鳞状上皮内病变（LSIL），传统涂片中最常见的是不典型鳞状细胞不能明确意义（ASCUS）。检测到的最常见高危型HPV和低危型HPV分别为16、18、56和61、142。
LBC联合HPV检测可提高敏感性和特异性，减少模糊结果；提高了依从性，因为两项检测均为阴性的患者可每5年进行一次筛查，从而延长了筛查间隔，这在资源有限的情况下很重要。
