Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulabhorn Royal Academy, Bangkok, Thailand.
Sci Rep. 2023 Jul 26;13(1):12134. doi: 10.1038/s41598-023-39206-2.
We conducted a prospective study to evaluate the prevalence of high-risk human papillomavirus (hr-HPV) positivity in women with atypical squamous cells of undetermined significance (ASC-US). Additionally, we assessed the association of hr-HPV positivity with the pathology of high-grade squamous intraepithelial lesions or worse (HSIL) and the risk of subsequent detection of squamous intraepithelial lesions. A total of 376 women were included, with 242 (64.4%) exhibiting hr-HPV positivity. The predominant HPV genotypes were 16, 52 and 58. Factors associated with the immediate detection of HSIL pathology included a colposcopic impression of high-grade lesions, hr-HPV positivity, HPV 16 positivity, HPV 18 positivity, HPV 58 positivity, age less than 40 years, and biopsy of two or more pieces. However, only the first three factors were statistically significant in multivariate analysis. Among the 291 women who continued surveillance for 6 months or more, the median follow-up period was 41.8 months (interquartile range [IQR] 26.5-54.0). The prevalence of subsequent HSIL in women with hr-HPV positivity versus negativity was 3.6% versus 0.98%, respectively. The median time to the subsequent detection of SIL was 28.7 months (IQR 14.9-41.7). In conclusion, women with ASC-US in our study had a high proportion of hr-HPV positivity. Type-specific HPV testing could play a pivotal role in the development of specific management protocols for women with ASC-US.Clinical trial registration: https://thaiclinicaltrials.org , TCTR20161017002.
我们进行了一项前瞻性研究，以评估意义不明确的非典型鳞状细胞（ASC-US）女性中高危型人乳头瘤病毒（hr-HPV）阳性的发生率。此外，我们评估了 hr-HPV 阳性与高级别鳞状上皮内病变或更差（HSIL）的病理学以及随后检测到鳞状上皮内病变的风险之间的关联。共纳入 376 名女性，其中 242 名（64.4%）存在 hr-HPV 阳性。主要的 HPV 基因型为 16、52 和 58。与立即检测到 HSIL 病理学相关的因素包括阴道镜下高级别病变印象、hr-HPV 阳性、HPV 16 阳性、HPV 18 阳性、HPV 58 阳性、年龄小于 40 岁以及活检两块或更多块。然而，只有前三个因素在多变量分析中具有统计学意义。在 291 名继续监测 6 个月或以上的女性中，中位随访期为 41.8 个月（四分位距 [IQR] 26.5-54.0）。hr-HPV 阳性与阴性女性中随后发生 HSIL 的患病率分别为 3.6%和 0.98%。随后检测到 SIL 的中位时间为 28.7 个月（IQR 14.9-41.7）。总之，我们研究中的 ASC-US 女性中有很高比例的 hr-HPV 阳性。HPV 型特异性检测可能在制定针对 ASC-US 女性的特定管理方案中发挥关键作用。临床试验注册：https://thaiclinicaltrials.org ，TCTR20161017002。
