Xie Han, Li Li, Zhu Tao, Zhou Hu, He Liang, Yang Fan, Chen Shi-Min, Huang Xiao-Yuan, Ma Ding, Hu Ting, Zhuang Liang
Department of Gynaecological Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
National Clinical Research Centre for Obstetrics and Gynaecology, Cancer Biology Research Centre (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2024 Dec;44(6):1303-1311. doi: 10.1007/s11596-024-2947-2. Epub 2024 Dec 14.
Our research aims to evaluate the diagnostic accuracy of colposcopy-guided biopsy (CGB) in detecting high-grade cervical lesions and explore how human papilloma virus (HPV) integration status and other factors affect its performance.
A retrospective cohort analysis involving 550 patients was conducted to evaluate whether the HPV integration plays a role in identifying high-grade cervical lesions and cervical cancer. Logistic regression models and area under the curve (AUC) calculations were employed.
Our findings revealed that 53.5% of CGB/surgery pairs demonstrated congruent diagnoses, whereas 17.1% showed underestimation and 29.5% overestimation. Furthermore, multivariate logistic regression analysis identified several key predictors for cervical intraepithelial neoplasia (CIN)2+ and CIN3+ according to surgical pathology. Notably, a CGB confirming CIN2+ [odds ratio (OR)=6.0, 95% confidence interval (CI): 3.9-9.1, P<0.001], high-grade cytology (OR=2.6, 95% CI: 1.4-1.9, P=0.003), and HPV integration positivity (OR=2.2, 95% CI: 1.3-3.5, P<0.001) emerged as significant factors for CIN2+. Similarly, for CIN3+ identification, CGB confirming CIN2+ (OR=5.3, 95% CI: 3.4-8.3, P<0.001), high-grade cytology (OR=2.6, 95% CI: 1.5-4.7, P=0.001), and HPV integration positivity (OR=2.0, 95% CI: 1.3-3.1, P=0.003) were independent predictors.
Our study highlights the innovative role of HPV integration testing as a pivotal adjunct to CGB and cytology, offering a comprehensive approach that may enhance the diagnostic precision for high-grade cervical lesions, ultimately achieving more precise management strategies.
我们的研究旨在评估阴道镜引导下活检（CGB）在检测高级别宫颈病变中的诊断准确性，并探讨人乳头瘤病毒（HPV）整合状态及其他因素如何影响其性能。
进行了一项涉及550例患者的回顾性队列分析，以评估HPV整合在识别高级别宫颈病变和宫颈癌中是否起作用。采用逻辑回归模型和曲线下面积（AUC）计算。
我们的研究结果显示，53.5%的CGB/手术配对显示诊断一致，而17.1%显示低估，29.5%显示高估。此外，多变量逻辑回归分析根据手术病理确定了宫颈上皮内瘤变（CIN）2+和CIN3+的几个关键预测因素。值得注意的是，CGB确诊为CIN2+[比值比（OR）=6.0，95%置信区间（CI）：3.9 - 9.1，P<0.001]、高级别细胞学检查（OR=2.6，95%CI：1.4 - 1.9，P=0.003）以及HPV整合阳性（OR=2.2，95%CI：1.3 - 3.5，P<0.001）是CIN2+的重要因素。同样，对于CIN3+的识别，CGB确诊为CIN2+（OR=5.3，95%CI：3.4 - 8.3，P<0.
