Department of Gynecologic Oncology, Zeynep Kamil Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Pathology, Zeynep Kamil Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Diagn Cytopathol. 2021 Apr;49(4):480-486. doi: 10.1002/dc.24705. Epub 2021 Feb 2.
Human papillomavirus (HPV) is a primary risk factor for cervical cancer. HPV 16 and 18 are the two most carcinogenic genotypes and have been reported in the majority of cervical cancer. High-risk HPVs (hrHPVs) other than HPV 16/18 cause approximately a quarter of cervical cancers. We aimed to present the colposcopy-guided biopsy results of non-16/18 hrHPV-infected women with negative cytology.
This is a retrospective cohort study conducted on 752 patients between the ages of 30-65 years with non-16/18 hrHPV and negative cytology undergoing colposcopy-guided biopsy at a tertiary gynecological cancer center between January-2016 and January-2019.
The mean age of the women was 42.35±9.41 years. Cervical intraepithelial neoplasia (CIN) 2+ lesion was detected in 49 (6.5%) women with negative cytology. The rate of CIN 2+ lesions in women with abnormal cytology was 12.8%. Patients with abnormal cytology had about 2.1 and 2.4 times increased the odds of CIN 2+ lesion in cervical biopsy and endocervical curettage specimens, respectively. CIN 3+ lesion was detected in 20 (2.7%) women with negative cytology. One (0.1%) of the patients with HPV 39 and negative cytology had invasive cervical cancer. The two most common HPV subtypes were HPV 31 and HPV 51.
The risk of cervical preinvasive lesions still can be detected and cannot be completely eliminated among hrHPV other than 16/18-infected women with negative cytology. Based on the results of this study, referral of non-16/18 hrHPV-infected women with negative cytology to colposcopy is supported as a credible and feasible strategy.
人乳头瘤病毒（HPV）是宫颈癌的主要危险因素。HPV16 和 18 是两种最具致癌性的基因型，在大多数宫颈癌中均有报道。除 HPV16/18 以外的高危型 HPV（hrHPV）约占宫颈癌的四分之一。我们旨在报告细胞学阴性的非 16/18hrHPV 感染妇女行阴道镜引导下活检的结果。
这是一项回顾性队列研究，纳入了 2016 年 1 月至 2019 年 1 月在一家三级妇科癌症中心行阴道镜引导下活检的 752 例年龄在 30-65 岁之间的非 16/18hrHPV 且细胞学阴性的患者。
女性的平均年龄为 42.35±9.41 岁。细胞学阴性的妇女中，有 49 例（6.5%）发现宫颈上皮内瘤变（CIN）2+病变。细胞学异常妇女的 CIN2+病变发生率为 12.8%。细胞学异常的患者，其在阴道镜活检和宫颈管搔刮标本中 CIN2+病变的优势比分别约为 2.1 和 2.4 倍。细胞学阴性的妇女中，有 20 例（2.7%）发现 CIN3+病变。1 例（0.1%）HPV39 且细胞学阴性的患者患有浸润性宫颈癌。最常见的两种 HPV 亚型为 HPV31 和 HPV51。
在细胞学阴性的非 16/18hrHPV 感染妇女中，仍能检测到宫颈前病变的风险，且不能完全消除。基于本研究结果，支持将细胞学阴性的非 16/18hrHPV 感染妇女转诊至阴道镜检查作为一种可靠且可行的策略。
