Liu Yang, Yin Yongxiang, Zhang Yi, Lin Luling, Zhao Min, Chen Qi
Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand.
Department of Pathology, Wuxi Maternity and Child Health Hospital Affiliated Nanjing Medical University, Wuxi, China.
Front Med (Lausanne). 2022 Mar 22;9:825228. doi: 10.3389/fmed.2022.825228. eCollection 2022.
A liquid-based cytology test was introduced for cervical cancer screening in the 2000s worldwide. However, the concordance of diagnostic findings between the liquid-based cytology test and cervical biopsy has not been fully investigated, especially the overall failure rate on the diagnosis of cervical cancer and high-grade squamous intraepithelial lesion (HSIL) by cytology testing. The aim of this retrospective study was to investigate the concordance between ThinPrep cytology and histology test in the diagnosis of cervical cancer and HSIL in HPV-positive women.
ThinPrep cytology test was performed in 2,472 HPV-positive women. Out of 2,472 HPV-positive women, the cervical biopsy was concurrently performed in 1,533 women. Data on the HPV type and the diagnostic findings of the ThinPrep cytology test and cervical biopsy were collected from our hospital electronic database. The concordance of diagnostic findings between cytology and histology was compared.
The rate of agreement in the diagnosis of the low-grade squamous intraepithelial lesion (LSIL) or HSIL between cervical biopsy and ThinPrep cytology test was 58 or 49%. The overall false negative rate in the diagnosis of cervical cancer and HSIL by ThinPrep cytology test was 6%. However, when considering the total number of HPV-positive women diagnosed with cervical cancer ( = 36) and HSIL ( = 117) by cervical biopsy, we found that a significant number of HPV-positive women with cervical cancer ( = 12, 33%), or women with HSIL ( = 77, 66%) were failed to be diagnosed by the ThinPrep cytology test. These HPV-positive women were either diagnosed with cervical infection or ASCUS, or LSIL.
Our data demonstrated that in order to ensure an accurate diagnosis, an immediate cervical biopsy in women with cervical infection or ASCUS or LSIL should be strongly recommended in clinical practice.
21世纪初，液基细胞学检测在全球范围内被引入用于宫颈癌筛查。然而，液基细胞学检测与宫颈活检之间诊断结果的一致性尚未得到充分研究，尤其是细胞学检测对宫颈癌和高级别鳞状上皮内病变（HSIL）诊断的总体失败率。这项回顾性研究的目的是调查在HPV阳性女性中，ThinPrep细胞学检查与组织学检查在宫颈癌和HSIL诊断中的一致性。
对2472名HPV阳性女性进行了ThinPrep细胞学检测。在这2472名HPV阳性女性中，1533名女性同时进行了宫颈活检。从我院电子数据库收集HPV类型以及ThinPrep细胞学检测和宫颈活检的诊断结果数据。比较了细胞学和组织学诊断结果的一致性。
宫颈活检与ThinPrep细胞学检测在低级别鳞状上皮内病变（LSIL）或HSIL诊断中的一致率分别为58%或49%。ThinPrep细胞学检测对宫颈癌和HSIL诊断的总体假阴性率为6%。然而，当考虑通过宫颈活检诊断为宫颈癌（n = 36）和HSIL（n = 117）的HPV阳性女性总数时，我们发现相当数量的宫颈癌HPV阳性女性（n = 12，33%）或HSIL女性（n = 77，66%）未被ThinPrep细胞学检测诊断出来。这些HPV阳性女性被诊断为宫颈感染或意义不明确的非典型鳞状细胞（ASCUS），或LSIL。
我们的数据表明，为确保准确诊断，在临床实践中应强烈建议对宫颈感染或ASCUS或LSIL的女性立即进行宫颈活检。
