Cramer H M, Skinner-Wannemuehler S E, Brown D R, Katz B P, Fife K H
Department of Pathology, School of Allied Health, Indianapolis, Indiana, USA.
Acta Cytol. 1997 Mar-Apr;41(2):261-8. doi: 10.1159/000332452.
To determine if cytologic abnormalities less striking than those usually considered diagnostic could predict the presence of human papillomavirus (HPV).
Cervical scrapings were obtained from 403 women and examined by conventional Papanicolaou staining and for the presence of low- and high-risk human HPV DNA. The cytologic smears from 63 HPV DNA-positive and 63 matched HPV DNA-negative patients whose smears were initially read as normal or inflammatory were reviewed by a single cytotechnologist and a cytopathologist, who were blind to the HPV result.
The cytologic diagnosis was upgraded to atypical squamous cells of undetermined significance (ASCUS) in nine cases and to low grade squamous intraepithelial lesion in one. All 10 upgraded cases were from the HPV DNA-positive group. A review diagnosis of ASCUS was significantly associated with both HPV in general and the presence of high-risk HPV DNA. Partial koilocytosis and multinucleation were associated with the detection of high-risk HPV DNA, while only partial koilocytosis was associated with the presence of low-risk HPV DNA.
Because infection with high-risk HPV types is associated with cervical neoplasia, partial koilocytosis and multinucleation should be viewed with greater concern and possibly added to the ASCUS definition.
确定比通常认为具有诊断意义的细胞学异常表现更不显著的情况是否能预测人乳头瘤病毒（HPV）的存在。
从403名女性获取宫颈刮片，采用传统巴氏染色法进行检查，并检测低危和高危人HPV DNA的存在情况。一名细胞技术专家和一名细胞病理学家对63例HPV DNA阳性和63例配对的HPV DNA阴性患者的细胞学涂片进行复查，这些涂片最初被判定为正常或炎症，复查人员对HPV检测结果不知情。
9例细胞学诊断升级为意义不明确的非典型鳞状细胞（ASCUS），1例升级为低级别鳞状上皮内病变。所有10例诊断升级的病例均来自HPV DNA阳性组。总体而言，复查诊断为ASCUS与HPV以及高危HPV DNA的存在均显著相关。部分挖空细胞形成和多核化与高危HPV DNA的检测相关，而只有部分挖空细胞形成与低危HPV DNA的存在相关。
由于高危HPV类型感染与宫颈肿瘤形成相关，应更加关注部分挖空细胞形成和多核化情况，并可能将其纳入ASCUS的定义中。
