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对日本年轻非典型意义的不明确鳞状细胞女性进行高危型人乳头瘤病毒检测

High-risk Papillomavirus Testing in Young Japanese Women with Atypical Squamous Cells of Undetermined Significance.

作者信息

Mitamura Takashi, Konno Yosuke, Kikawa Satomi, Iwaki Yutaka, Iwaki Kurumi, Tanuma Fumie, Kataoka Soromon

机构信息

Department of Obstetrics and Gynecology, Hakodate Central General Hospital, 33-2, Honcho, Hakodate, Japan.

Department of Obstetrics and Gynecology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Japan.

出版信息

J Cytol. 2019 Jul-Sep;36(3):180-183. doi: 10.4103/JOC.JOC_148_17.

Abstract

INTRODUCTION

The mortality due to uterine cervical cancer has been gradually increasing in women under 40 years of age (U40) in Japan. We investigated the effect of high-risk papillomavirus (HR-HPV) on U40 subjects without any overt cytological abnormalities.

MATERIALS AND METHODS

We retrospectively examined the clinical data, including the findings of a cobas 4800 HPV test that was approved in Japan in 2013 to triage women with atypical squamous cells of undetermined significance (ASC-US) and a histological examination in 589 Japanese women.

RESULTS

The overall prevalence rate of HR-HPV was 34.5%. Biopsy-confirmed cervical intraepithelial neoplasia (CIN) 2, or worse (CIN2+) was identified in 45.1% (23/51) of HR-HPV-positive women with ASC-US, who underwent colposcopy immediately. The mean period from the HPV test to the diagnosis of CIN2+ was 3.7 months. CIN2+ was more common (69.6%) in U40 patients. The rates of single or multiple infections of HPV-16, HPV-18, and 12 other HR-HPV (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) in CIN2+ U40 patients were 31.3%, 0%, and 81.3%, respectively. The relative risk for CIN 2+ among U40 women with HPV-16 was not significantly different from that of the patients with infection of any of the 12 other HR-HPVs.

CONCLUSION

The results of this study suggest that the 12 other HR-HPVs have a potential to generate high-grade cervical lesions among young women, and the examination rate of colposcopy should be increased.

摘要

引言

在日本,40岁以下女性(U40)因子宫颈癌导致的死亡率一直在逐渐上升。我们调查了高危型人乳头瘤病毒(HR-HPV)对无明显细胞学异常的U40受试者的影响。

材料与方法

我们回顾性检查了589名日本女性的临床数据,包括2013年在日本获批用于对意义不明确的非典型鳞状细胞(ASC-US)女性进行分流的cobas 4800 HPV检测结果以及组织学检查结果。

结果

HR-HPV的总体患病率为34.5%。在立即接受阴道镜检查的ASC-US且HR-HPV阳性的女性中,45.1%(23/51)经活检确诊为宫颈上皮内瘤变(CIN)2级或更严重(CIN2+)。从HPV检测到诊断为CIN2+的平均时间为3.7个月。CIN2+在U40患者中更为常见(69.6%)。CIN2+的U40患者中HPV-16、HPV-18和其他12种HR-HPV(31、33、35、39、45、51、52、56、58、59、66和68)单一或多重感染率分别为31.3%、0%和81.3%。HPV-16感染的U40女性中CIN 2+的相对风险与其他12种HR-HPV感染患者的相对风险无显著差异。

结论

本研究结果表明,其他12种HR-HPV有可能在年轻女性中引发高级别宫颈病变,应提高阴道镜检查率。

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