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阴道镜检查前的人乳头瘤病毒和细胞学检测结果是否会改变阴道镜醋酸肉眼检查的病理分级?一项回顾性研究。

Do Human Papilloma Virus and Cytological Testing Results Before Colposcopy Alter the Pathological Grading of Colposcopy Acetic Acid Visual Examination?: A Retrospective Study.

作者信息

Gao Songkun, Qian Boyang, Wang Tong, Wang Jiandong

机构信息

Gynecologic Oncology Department,Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, People's Republic of China.

Nantong University, Nantong, Jiangsu, 226019, People's Republic of China.

出版信息

Int J Womens Health. 2025 Jan 30;17:201-209. doi: 10.2147/IJWH.S490355. eCollection 2025.

Abstract

OBJECTIVE

To understand whether human papillomavirus (HPV) and cytological testing (TCT [ie, "thinprep" cytological testing]) results can provide more information beyond visual information for vaginal colposcopy examinations to upgrade or downgrade the visual diagnosis of vaginal colposcopy.

PATIENTS AND METHODS

Data from 519 patients, who underwent vaginal colposcopy at the Beijing Obstetrics and Gynecology Hospital (Beijing, China) between January and June 2020, were included. Preoperative HPV and TCT results were statistically analyzed, and were divided into 3 groups according to postoperative cervical tissue pathological diagnosis: negative; low-grade squamous intraepithelial (LSIL); and high-grade squamous intraepithelial lesion (HSIL). Positive and negative predictive values for cervical inflammation, LSIL, and HSIL in patients diagnosed using vaginal colposcopy, based on cervical pathological grouping, and differences in HPV and TCT results among patients who underwent vaginal colposcopy, were analyzed.

RESULTS

The age of patients diagnosed with cervicitis, LSIL, and HSIL using colposcopy gradually decreased, and the proportion of HPV16/18 infection in the HSIL group was significantly higher than the other 2 groups. There were significant differences in TCT results among the groups. According to pathological results from cervical tissue specimens, among all groups diagnosed using colposcopy, the age of the HSIL group was significantly younger than that of the other groups, and the proportion of patients with a TCT greater than LSIL was significantly higher than that of the other groups.

CONCLUSION

HPV did not provide additional information for vaginal colposcopy. Young(er) patients and those with a TCT greater than LSIL may consider upgrading the vaginal colposcopy diagnosis based on imaging information.

摘要

目的

了解人乳头瘤病毒(HPV)和细胞学检测(TCT[即“薄层液基细胞学检测”])结果能否为阴道镜检查提供超出视觉信息的更多信息,以提升或降低阴道镜视觉诊断的级别。

患者与方法

纳入2020年1月至6月在北京妇产医院(中国北京)接受阴道镜检查的519例患者的数据。对术前HPV和TCT结果进行统计学分析,并根据术后宫颈组织病理诊断分为3组:阴性;低级别鳞状上皮内病变(LSIL);高级别鳞状上皮内病变(HSIL)。分析基于宫颈病理分组,阴道镜检查诊断的患者中宫颈炎症、LSIL和HSIL的阳性和阴性预测值,以及接受阴道镜检查患者的HPV和TCT结果差异。

结果

阴道镜诊断为宫颈炎、LSIL和HSIL的患者年龄逐渐降低,HSIL组中HPV16/18感染比例显著高于其他两组。各组TCT结果存在显著差异。根据宫颈组织标本的病理结果,在所有阴道镜诊断的组中,HSIL组患者年龄显著低于其他组,TCT大于LSIL的患者比例显著高于其他组。

结论

HPV未为阴道镜检查提供额外信息。年轻患者以及TCT大于LSIL的患者可考虑根据影像信息提升阴道镜诊断级别。

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Chromocolposcopy with fluorescein sodium for detection of premalignant and malignant lesions of the cervix: A cross-sectional study.
Int J Gynaecol Obstet. 2024 Apr;165(1):169-175. doi: 10.1002/ijgo.15283. Epub 2023 Dec 10.
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J Prim Care Community Health. 2023 Jan-Dec;14:21501319231198942. doi: 10.1177/21501319231198942.
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European consensus statement on expert colposcopy.欧洲专家阴道镜共识声明。
Eur J Obstet Gynecol Reprod Biol. 2023 Nov;290:27-37. doi: 10.1016/j.ejogrb.2023.08.369. Epub 2023 Aug 31.
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