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人乳头瘤病毒自我采样和尿液采样检测以及宫颈上皮内瘤变的管理和短期结局:一项前瞻性观察研究。

Human papillomavirus self-sampling and urine-sampling tests and the management and short-term outcomes of cervical intraepithelial neoplasia: A prospective observational study.

机构信息

Department of Gynecology, Sapporo Medical University, Sapporo, Japan.

Department of Obstetrics and Gynecology, Steel Memorial Muroran Hospital, Muroran, Japan.

出版信息

J Obstet Gynaecol Res. 2024 Oct;50(10):1801-1807. doi: 10.1111/jog.16082. Epub 2024 Sep 11.

Abstract

AIM

The importance of human papillomavirus (HPV) co-testing using physician-, self-, and urine-collected samples to predict cervical intraepithelial neoplasia (CIN) grade 1-2 prognoses has not been previously reported. Therefore, this study aimed to investigate outcomes of patients with CIN 1-2 who simultaneously underwent physician-, self-, and urine-collection sampling tests.

METHODS

This study was conducted in Japan between October 2019 and November 2022 and examined the proportion of cases with CIN 1-2 progressions, the percentage of cases with persistent CIN 1-2, and the outcome differences according to the results of physician-, self-, and urine-sampling tests.

RESULTS

There were 105 and 59 CIN 1 and 2 cases, respectively, with progression or persistence in 27 (29.3%) and 21 (50.0%) cases, respectively. The median follow-up was 20 and 12 months, respectively. Progression and persistence of CIN 1 were significantly associated with HPV-positive physician- and self-collected samples. No significant difference was observed between cases with CIN 2 who had HPV-positive and HPV-negative results using any sampling method.

CONCLUSIONS

Physician- and self-testing for HPV are crucial for predicting disease progression risk in CIN 1 cases. Future research with an extended observation period and consideration of the progression risks is warranted.

摘要

目的

尚未有研究报道过使用医师采样、自我采样和尿液采集样本进行人乳头瘤病毒(HPV)联合检测对预测宫颈上皮内瘤变(CIN)1-2 级预后的重要性。因此,本研究旨在探讨同时接受医师采样、自我采样和尿液采集样本检测的 CIN 1-2 患者的结局。

方法

本研究于 2019 年 10 月至 2022 年 11 月在日本进行,检查了 CIN 1-2 进展病例的比例、CIN 1-2 持续病例的百分比以及根据医师采样、自我采样和尿液采样检测结果的差异。

结果

CIN 1 和 2 分别有 105 例和 59 例,进展或持续分别为 27 例(29.3%)和 21 例(50.0%)。中位随访时间分别为 20 个月和 12 个月。CIN 1 的进展和持续与 HPV 阳性的医师采样和自我采样样本显著相关。HPV 阳性和 HPV 阴性结果的 CIN 2 病例在任何采样方法中均无显著差异。

结论

医师采样和自我检测 HPV 对于预测 CIN 1 病例的疾病进展风险至关重要。未来的研究需要延长观察期并考虑进展风险。

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