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巴氏涂片检查在伊朗的基础地位,原发性人乳头瘤病毒基因分型在替代方面是否具有成本效益?一项队列研究。

The Fundamental Place of Pap Test in Iran, Does Primary HPV-Genotyping Seem Cost-Effective in Replace? A Cohort Study.

作者信息

Zafarbakhsh Azam, Behnamfar Fariba, Shariati Matin, Vaezi Atefeh, Seresht Leila Mousavi

机构信息

Department of Urogynecology, Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Gynecology Oncology, Obstetrics, and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Int J Prev Med. 2025 Apr 24;16:21. doi: 10.4103/ijpvm.ijpvm_283_23. eCollection 2025.


DOI:10.4103/ijpvm.ijpvm_283_23
PMID:40376076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12080934/
Abstract

BACKGROUND: Human papillomavirus (HPV) is a known risk factor for cervical cancer, and currently, primary HPV typing is recommended for screening instead of cervical cytology. However, there are limited studies on the prevalence of HPV in Iran. METHODS: This cross-sectional study evaluated the liquid-based cervical smears of 700 women with no history of HPV vaccination and cervical dysplastic disease from 2017 to 2020 in Isfahan, Iran. Here, we compare the prevalence of HPV genotypes using COBAS with Pap smear cytology results in evaluating the most appropriate cervical cancer screening test. RESULTS: The prevalence of HPV infection was 23.3%, including 8.7% with HPV 16/18 and 14.6% with other HR (high-risk) HPVs. In cytology reports, 8 out of 16 individuals with high-risk lesions were negative for any type of HPV; on the other hand, there were 129 HR HPV-positive patients out of 570 negative or low-risk Pap smear results. CONCLUSIONS: It assumed that there is no superiority for HPV genotyping over cytology or vice versa in detecting high-risk patients for cervical cancer; as only 26.8% of women with HPV show abnormal cytology; and from those with normal cytology, 17.9% were positive for HR HPV.

摘要

背景:人乳头瘤病毒(HPV)是宫颈癌已知的危险因素,目前,推荐进行HPV初筛而非宫颈细胞学检查。然而,关于伊朗HPV流行情况的研究有限。 方法:这项横断面研究评估了2017年至2020年期间伊朗伊斯法罕700名无HPV疫苗接种史和宫颈发育异常疾病的女性的液基宫颈涂片。在此,我们比较了使用COBAS检测HPV基因型的患病率与巴氏涂片细胞学检查结果,以评估最合适的宫颈癌筛查试验。 结果:HPV感染率为23.3%,其中HPV 16/18感染率为8.7%,其他高危(HR)型HPV感染率为14.6%。在细胞学报告中,16例高危病变个体中有8例任何类型的HPV检测均为阴性;另一方面,在570例巴氏涂片结果为阴性或低危的患者中,有129例HR HPV阳性患者。 结论:在检测宫颈癌高危患者方面,HPV基因分型并不优于细胞学检查,反之亦然;因为只有26.8%的HPV感染女性细胞学检查异常;而在细胞学检查正常的女性中,17.9%的HR HPV呈阳性。

相似文献

[1]
The Fundamental Place of Pap Test in Iran, Does Primary HPV-Genotyping Seem Cost-Effective in Replace? A Cohort Study.

Int J Prev Med. 2025-4-24

[2]
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[3]
The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology.

Ginekol Pol. 2018

[4]
Assessing national cervical cancer screening guidelines: Results from an HIV testing clinic also screening for cervical cancer and HPV in Soweto, South Africa.

PLoS One. 2021

[5]
[Investigation of human papillomavirus prevalence in women in Eskişehir, Turkey by Pap smear, hybrid capture 2 test and consensus real-time polymerase chain reaction and typing with pyrosequencing method].

Mikrobiyol Bul. 2016-1

[6]
Determination of Prevalence and Genotype Distribution of High-Risk Human Papillomavirus in Varamin (Iran).

Diagn Cytopathol. 2025-3-19

[7]
The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomised trial cohort through three screening rounds.

Health Technol Assess. 2014-4

[8]
[Health technology assessment report: Computer-assisted Pap test for cervical cancer screening].

Epidemiol Prev. 2012

[9]
Comparison of HPV test versus conventional and automation-assisted Pap screening as potential screening tools for preventing cervical cancer.

BJOG. 2004-8

[10]
Burden and Associated Genotype Patterns of High-Risk Human Papilloma Virus Infection and Cervical Cytology Abnormalities among Women in Central India.

Infect Dis Obstet Gynecol. 2022

本文引用的文献

[1]
Epidemiology and survival of cervical cancer in Iran based on national cancer registry data (2008-2014).

Front Oncol. 2023-4-19

[2]
Cost-Effectiveness of HPV vaccination; Need for Economic and Social Policy Intervention.

Arch Iran Med. 2022-5-1

[3]
Optimal human papillomavirus vaccination strategies to prevent cervical cancer in low-income and middle-income countries in the context of limited resources: a mathematical modelling analysis.

Lancet Infect Dis. 2021-11

[4]
The prevalence of 30 HPV genotypes detected by EUROArray HPV in cervical samples among unvaccinated women from Vojvodina province, Serbia.

PLoS One. 2021

[5]
2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors.

J Low Genit Tract Dis. 2020-4

[6]
The risk of cervical cancer after cervical intraepithelial neoplasia grade 3: A population-based cohort study with 80,442 women.

Gynecol Oncol. 2020-1-20

[7]
HPV genotype distribution among women with normal and abnormal cervical cytology in Turkey.

Rev Esp Quimioter. 2019-12

[8]
Prevalence and genotype distribution of human papillomavirus infection among women: A population-based study in Dali Bai Autonomous Prefecture, Yunnan Province, China.

J Med Virol. 2019-4-21

[9]
Cancer Control in Low- and Middle-Income Countries: Is It Time to Consider Screening?

J Glob Oncol. 2019-3

[10]
The interaction of high and low-risk human papillomavirus genotypes increases the risk of developing genital warts: A population-based cohort study.

J Cell Biochem. 2019-3-13

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