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产前检查期间的机会性宫颈癌筛查:迈向早期发现的一小步。

Opportunistic Cervical Cancer Screening During Antenatal Visits: A Small Step Toward Early Detection.

作者信息

Verma Ruchi, Sharma Ritu, Mishra Pinky, Mishra Neha

机构信息

Obstetrics and Gynaecology, Government Institute of Medical Sciences, Greater Noida, IND.

Obstetrics and Gynaecology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.

出版信息

Cureus. 2025 Aug 5;17(8):e89433. doi: 10.7759/cureus.89433. eCollection 2025 Aug.

DOI:10.7759/cureus.89433
PMID:40918868
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12410594/
Abstract

Background Cervical cancer remains a significant public health concern in India. The objective of this study was to compare cytological abnormalities and HPV positivity rates between pregnant and non-pregnant women. Materials and methods This prospective observational study was performed at a tertiary care center in North India. A total of 120 women were included in the study, with 60 in each group. Group A included women who were pregnant, and Group B included non-pregnant women. Conventional Pap smear and co-testing (liquid-based cytology (LBC) and human papillomavirus deoxyribonucleic acid (HPV DNA)) were done on all the participants. The smears were interpreted according to the Bethesda system of classification. The results in the two groups were compared. Follow-up and management were done as per standard guidelines. Results Cervical smear was satisfactory in 112 (93.3%) and 116 (96.7%) of women who underwent conventional Pap smear and LBC, respectively. Among the premalignant lesions in Group A, atypical squamous cells of undetermined significance (ASC-US) were found in four (6.67%) of patients, and low-grade intraepithelial lesion (LSIL) was found in two (3.33%) of patients. In Group B, ASC-US was seen in five (8.33%), LSIL in three (5%), and high-grade squamous intraepithelial lesion (HSIL) in one (1.6%) case, respectively. The women in both groups who tested positive for HPV DNA were retested as per guidelines. Conclusions The prevalence of cytological abnormalities and HPV DNA positivity was corroborated well in both pregnant and non-pregnant women. Due to the increased number of antenatal visits and institutional deliveries, we would like to emphasize that screening for cervical cancer can be done by either HPV DNA or cytology in the antenatal period.

摘要

背景

宫颈癌仍是印度一个重大的公共卫生问题。本研究的目的是比较孕妇和非孕妇的细胞学异常情况及人乳头瘤病毒(HPV)阳性率。

材料与方法

这项前瞻性观察性研究在印度北部的一家三级医疗中心进行。共有120名女性纳入研究,每组60名。A组为孕妇,B组为非孕妇。对所有参与者进行了传统巴氏涂片检查及联合检测(液基细胞学检查(LBC)和人乳头瘤病毒脱氧核糖核酸(HPV DNA)检测)。涂片根据贝塞斯达分类系统进行解读。比较两组的结果。按照标准指南进行随访和管理。

结果

分别进行传统巴氏涂片检查和LBC检查的女性中,宫颈涂片结果满意的分别有112例(93.3%)和116例(96.7%)。在A组的癌前病变中,4例(6.67%)患者发现意义不明确的非典型鳞状细胞(ASC-US),2例(3.33%)患者发现低级别上皮内病变(LSIL)。在B组中,分别有5例(8.33%)出现ASC-US,3例(5%)出现LSIL,1例(1.6%)出现高级别鳞状上皮内病变(HSIL)。两组中HPV DNA检测呈阳性的女性均按指南进行了重新检测。

结论

孕妇和非孕妇的细胞学异常情况及HPV DNA阳性率均得到了充分证实。由于产前检查次数和住院分娩数量的增加,我们想强调在孕期可通过HPV DNA检测或细胞学检查进行宫颈癌筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d8/12410594/c0a1f7fdae40/cureus-0017-00000089433-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d8/12410594/c0a1f7fdae40/cureus-0017-00000089433-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d8/12410594/c0a1f7fdae40/cureus-0017-00000089433-i01.jpg

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本文引用的文献

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Cervical Cancer Elimination. 90:70:90. Together We Can.消除宫颈癌。90:70:90。我们携手共进。
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Screening for Cervical Cancer in Pregnancy.孕期宫颈癌筛查
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