Schneider A, Zahm D M, Kirchmayr R, Schneider V L
Department of Gynecology, Friedrich Schiller University, Jena, Germany.
Am J Obstet Gynecol. 1996 May;174(5):1534-41. doi: 10.1016/s0002-9378(96)70602-6.
A commercial test for human papillomavirus detection (hybrid capture assay) was examined for its potential value to augment the sensitivity of cytologic study or cervicography for screening for cervical intraepithelial neoplasia grade 2/3.
In a cohort of 967 women with a mean age of 37.1 years who underwent routine cytologic screening, cytologic examination, cervicography, and testing for high-risk human papillomavirus by the hybrid capture assay were compared for their ability to detect cervical intraepithelial neoplasia grade 2/3. Cervical punch biopsy specimens were taken in 20.5% (198/967) patients because they had an atypical or positive cervigram or abnormal cytologic results in the primary screening smears. The data were analyzed by two-tailed chi(2) and Fisher's exact test.
Thirty-eight patients were diagnosed with cervical intraepithelial neoplasia grade 2/3 (prevalence 3.9%) by histologic study. Cytologic study identified 29%, cervicography 45%, and testing for high-risk human papillomavirus 50% of cervical intraepithelial neoplasia grade 2/3. When combined, detection of high-risk human papillomavirus or cervicography augmented sensitivity of cytologic study to 58% (p = 0.01) with positive predictive values of 23% and 17%, respectively. Results of the different techniques should be interpreted in relationship to each other and not as absolute values because collection of specimens for cytologic study was done with cotton swabs, which may be suboptimal for screening but is general practice in Germany.
Screening for cervical intraepithelial neoplasia grade 2/3 can significantly be improved by human papillomavirus testing with the hybrid capture assay.
检测一种用于人乳头瘤病毒检测的商业测试（杂交捕获试验），以评估其在提高细胞学检查或宫颈造影筛查宫颈上皮内瘤变2/3级敏感性方面的潜在价值。
在一个平均年龄为37.1岁、接受常规细胞学筛查的967名女性队列中，比较了细胞学检查、宫颈造影以及通过杂交捕获试验检测高危人乳头瘤病毒在检测宫颈上皮内瘤变2/3级方面的能力。20.5%（198/967）的患者因初次筛查涂片出现非典型或阳性宫颈造影结果或异常细胞学结果而进行了宫颈穿刺活检。数据采用双侧卡方检验和Fisher精确检验进行分析。
经组织学研究，38名患者被诊断为宫颈上皮内瘤变2/3级（患病率3.9%）。细胞学检查识别出29%的宫颈上皮内瘤变2/3级病例，宫颈造影识别出45%，高危人乳头瘤病毒检测识别出50%。当联合使用时，高危人乳头瘤病毒检测或宫颈造影可将细胞学检查的敏感性提高至58%（p = 0.01），阳性预测值分别为23%和17%。不同技术的结果应相互关联解读，而非作为绝对值，因为细胞学检查标本是用棉签采集的，这对于筛查可能并非最佳，但在德国是常规做法。
通过杂交捕获试验进行人乳头瘤病毒检测可显著提高宫颈上皮内瘤变2/3级的筛查效果。
