Health Sciences Research Centre (CICS), Faculty of Health Sciences, University of Beira Interior (UBI), Covilha, Portugal.
Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal.
Asian Pac J Cancer Prev. 2021 Jun 1;22(6):1907-1912. doi: 10.31557/APJCP.2021.22.6.1907.
Human papillomavirus (HPV) screening has significantly reduced cervical cancer (CC) mortality. Women who consecutively test positive for high-risk HPV without and minor changes on reflex cytology (atypical squamous cells of undetermined significance [ASC-US] or low-grade squamous intraepithelial lesion [LSIL]) or dysplasia on cervical colposcopy-oriented biopsy are always referred to colposcopy. The aim of the present study was to assess whether this guidance is appropriate for COBAS HPV testing with reflex cytology.
A cross-sectional, retrospective study was carried out in 5,227 women who underwent routine CC screening over a period of five years (2012-2017). All HPV tests were performed using Cobas®4800 HPV. The study included women attending gynecology appointments whose first HPV test was positive and who had any type of follow-up. Patients' HPV test results as well as cytology and biopsy findings obtained during the abovementioned period were analyzed. A descriptive and comparative statistical study was conducted using this data.
A total of 765 out of 6003 HPV tests performed in 5,227 women were positive, and 141 women who had a positive HPV test (with negative for intraepithelial lesion or malignancy [NILM] or inflammation, or ASC-US and LSIL cytology, but no lesions on colposcopy, or absence of dysplasia on histology) repeated the HPV test at least once. Of these 141 women, 6 were diagnosed with high-grade squamous intraepithelial lesion (HSIL) during the follow-up period. All cases of HSIL were diagnosed after the second HPV test.
This study shows that, at cervical cancer screening, all women testing positive for HPV regardless of Pap smear result should be referred to colposcopy.
人乳头瘤病毒（HPV）筛查显著降低了宫颈癌（CC）的死亡率。连续检测出高危 HPV 且巴氏涂片（非典型鳞状细胞意义不明确[ASC-US]或低级别鳞状上皮内病变[LSIL]）或宫颈阴道镜导向活检无轻微变化或无发育不良的女性，通常会转介行阴道镜检查。本研究旨在评估 COBAS HPV 检测联合巴氏涂片细胞学检查的指导原则是否恰当。
对 5227 名连续五年（2012-2017 年）接受常规 CC 筛查的女性进行了横断面、回顾性研究。所有 HPV 检测均使用 Cobas®4800 HPV 进行。本研究纳入了妇产科就诊的女性，她们的首次 HPV 检测为阳性，且有任何类型的随访。分析了患者 HPV 检测结果以及在此期间获得的细胞学和活检结果。使用该数据进行了描述性和对比性统计研究。
在 5227 名女性中，6003 次 HPV 检测中有 765 次呈阳性，141 名 HPV 检测阳性（巴氏涂片结果为阴性，或有炎症、非典型鳞状细胞不能明确意义或低度鳞状上皮内病变，阴道镜检查未见病变，或组织学未见发育不良）的女性至少重复检测了一次 HPV。在这 141 名女性中，有 6 名在随访期间被诊断为高级别鳞状上皮内病变（HSIL）。所有 HSIL 病例均在第二次 HPV 检测后确诊。
本研究表明，在宫颈癌筛查中，所有 HPV 检测阳性的女性，无论巴氏涂片结果如何，均应转介行阴道镜检查。
