Aydoğmuş Hüseyin, Aydoğmuş Serpil
Atatürk Research and Training Hospital, Department of Gynecology and Obstetrics, İzmir Katip Çelebi University, Turkey. Email:
Asian Pac J Cancer Prev. 2019 Feb 26;20(2):417-420. doi: 10.31557/APJCP.2019.20.2.417.
Objective: Current guidelines suggest annual co-test follow-up in non-16/18 high-risk HPV positive patients without abnormal cytologic findings. Considering the relatively high false-negative rates of cervical cytology, a follow-up period of one year might constitute an additional risk for development of cervical malignancies in these patients. The current study aims to evaluate colposcopic biopsy results of cytologically normal patients detected to carry high risk HPV by screening tests. Materials and Methods: A total of 160 patients with normal cervical cytology and high-risk HPV subtypes who underwent colposcopic examination were included in the study. Patients were divided into two groups according to their HPV results: HPV 16-18 and other types (non-16/18 high-risk subtypes). ECC, cervical biopsy, LEEP/ conization results were analyzed for both groups. Histopathological results of the groups were compared in terms of ≤LSIL, HSIL and cervical cancer rates. Results: Cervical biopsy results in the “16-18” group were assessed as HSIL in 40 (48.2%) patients, LSIL in 6 patients (7.2%) and normal in 37 (44.6%) patients. ECC results revealed HSIL in 9 (10.8%) patients and LSIL in 1 (1.2%) patient. Nineteen out of 42 patients who underwent LEEP/conization had HSIL (surgical margin positivity was reported in 4 cases), while 3 patients had LSIL. None of the cases had cervical carcinoma. Conclusion: The present study detected that 15.6% of women infected with non-16/18 high-risk HPV subgroups developed ≥HSIL lesions. Although this rate seems lower than HPV 16-18 group, it is still too high to be overlooked. In conclusion, we suggest further clinical trials with larger number of patients to be conducted on this topic.
当前指南建议，对于非16/18型高危人乳头瘤病毒（HPV）阳性且细胞学检查结果无异常的患者，进行每年一次的联合检测随访。鉴于宫颈细胞学检查的假阴性率相对较高，一年的随访期可能会给这些患者带来宫颈恶性肿瘤发展的额外风险。本研究旨在评估通过筛查检测出携带高危HPV的细胞学正常患者的阴道镜活检结果。材料与方法：本研究纳入了160例宫颈细胞学正常且高危HPV亚型的患者，这些患者均接受了阴道镜检查。根据HPV检测结果将患者分为两组：HPV 16 - 18型组和其他类型（非16/18型高危亚型组）。分析两组患者的宫颈管搔刮术（ECC）、宫颈活检、环形电切术（LEEP）/锥形切除术结果。比较两组的组织病理学结果，包括低级别鳞状上皮内病变（≤LSIL）、高级别鳞状上皮内病变（HSIL）和宫颈癌发生率。结果：“16 - 18”型组中，40例（48.2%）患者的宫颈活检结果被评估为HSIL，6例（7.2%）患者为LSIL，37例（44.6%）患者为正常。ECC结果显示，9例（10.8%）患者为HSIL，1例（1.2%）患者为LSIL。42例行LEEP/锥形切除术的患者中，19例有HSIL（4例报告手术切缘阳性），3例有LSIL。所有病例均无宫颈癌。结论：本研究发现，感染非16/18型高危HPV亚组的女性中有15.6%发生了≥HSIL病变。尽管该比率似乎低于HPV 16 - 18型组，但仍高到不容忽视。总之，我们建议针对该主题开展更多患者参与的进一步临床试验。
