Wu Tao, Chen Xiangbai, Zheng Baowen, Li Juan, Xie Fengxiang, Ding Xiangdong, Zeng Zhengyu, Zhao Chengquan
Department of Pathology, KingMed Diagnostics, Guangzhou, Guangdong, China.
Department of Pathology, Baylor Scott and White Health, College Station, Texas.
J Am Soc Cytopathol. 2019 Jul-Aug;8(4):206-211. doi: 10.1016/j.jasc.2019.01.004. Epub 2019 Jan 18.
Cervical cancer remains an important public health problem in Chinese women owing to the lack of a national screening program. The aim of the present study was to evaluate human papillomavirus (HPV) and Papanicolaou (Pap) test results preceding the histologic diagnosis of cervical intraepithelial neoplasia 2/3 (CIN2/3) in China's largest College of American Pathologists-certified clinical laboratory.
All cases of CIN2/3 histologically diagnosed from January 2011 to August 2016 were retrieved from the pathology department records. The Pap cytology and HPV test results from the 6 months before the CIN2/3 diagnoses were analyzed.
A total of 5699 patients with histologically diagnosed CIN2/3 had previous Pap and/or HPV Hybrid Capture 2 testing results within the previous 6 months. The average age was 39.5 years (range, 16-82 years). Of these patients, 4288 had Pap test findings (average, 1.5 months) available. The results were high-grade squamous intraepithelial lesion in 44.1%, low-grade squamous intraepithelial lesion in 20.0%, atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion, in 16.0%, atypical squamous cells of undetermined significance, in 12.3%, atypical glandular cells in 0.7%, and negative in 6.9%. Of the 5699 patients, 2546 had HPV Hybrid Capture 2 test results (average, 1.4 months) available. Of these, 91.7% had positive results and 8.3% had negative results. Of 1135 patients with both previous Pap and HPV results, 7.1% had negative HPV results and 8.0% had negative Pap results (P = 0.38). Only 21 patients (1.9%) had double negative results.
The present study has reported the previous results of HPV testing and Pap cytology for patients with high-grade cervical squamous precursor lesions in a population of women in China who had not undergone intensive previous screening. Both high-risk HPV and Pap cytology had similar negative testing rates for these women, although double negative results were less common. These results support the value of combined testing in the detection of cervical cancer precursors.
由于缺乏全国性筛查项目,宫颈癌仍是中国女性面临的一个重要公共卫生问题。本研究旨在评估中国最大的美国病理学家学会认证临床实验室中,在宫颈上皮内瘤变2/3(CIN2/3)组织学诊断之前的人乳头瘤病毒(HPV)和巴氏(Pap)检测结果。
从病理科记录中检索出2011年1月至2016年8月间组织学诊断为CIN2/3的所有病例。分析CIN2/3诊断前6个月的巴氏细胞学和HPV检测结果。
共有5699例组织学诊断为CIN2/3的患者在之前6个月内有巴氏和/或HPV第二代杂交捕获检测结果。平均年龄为39.5岁(范围16 - 82岁)。其中4288例有巴氏检测结果(平均间隔1.5个月)。结果显示,高级别鳞状上皮内病变占44.1%,低级别鳞状上皮内病变占20.0%,非典型鳞状细胞,不能排除高级别鳞状上皮内病变占16.0%,意义不明确的非典型鳞状细胞占12.3%,非典型腺细胞占0.7%,阴性占6.9%。5699例患者中,2546例有HPV第二代杂交捕获检测结果(平均间隔1.4个月)。其中,91.7%为阳性结果,8.3%为阴性结果。在1135例同时有巴氏和HPV检测结果的患者中,7.1%的HPV检测结果为阴性,8.0%的巴氏检测结果为阴性(P = 0.38)。仅有21例(1.9%)为双阴性结果。
本研究报告了在中国一组未接受过密集筛查的女性人群中,高级别宫颈鳞状前驱病变患者之前的HPV检测和巴氏细胞学检测结果。对于这些女性,高危HPV和巴氏细胞学检测的阴性率相似,尽管双阴性结果较少见。这些结果支持联合检测在宫颈癌前驱病变检测中的价值。