Maiman M, Fruchter R G, Sedlis A, Feldman J, Chen P, Burk R D, Minkoff H
Department of Obstetrics and Gynecology, State University of New York-Health Science Center at Brooklyn 11203, USA.
Gynecol Oncol. 1998 Mar;68(3):233-9. doi: 10.1006/gyno.1998.4938.
The objective was to evaluate the sensitivity and specificity of cervical cytology in women infected with the human immunodeficiency virus (HIV), risk factors for abnormal cytology in HIV-infected and uninfected women, and risk factors for histologic diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-infected women.
Methods included a cross-sectional analysis of cervical cytology, colposcopic impression, and histology in 248 HIV-infected women and multivariate analyses of risk factors for abnormal cytology in 253 HIV-infected and 220 uninfected women and risk factors for CIN in 186 HIV-infected women.
The sensitivity and specificity of cytology for all CIN grades were 0.60 and 0.80 and, for high-grade CIN, 0.83 and 0.74. The prevalence of abnormal cytology was 32.9% in HIV-infected and 7.6% in HIV-negative women. Independent risk factors for abnormal cytology were immunodeficiency [odds ratio (OR) 8-17, P < 0.001] and human papillomavirus (HPV) infection (OR = 5, P < 0.001). The prevalence of CIN on histology was 32% in HIV-infected women, and the only independent risk factor for CIN was oncogenic HPV type (OR = 5, P = 0.005).
Given the high prevalence of abnormal cytology and CIN in HIV-infected women, cytologic screening has significant limitations. Both immunodeficiency and type of HPV infection are important risk factors.
评估宫颈细胞学检查对感染人类免疫缺陷病毒（HIV）女性的敏感性和特异性，HIV感染和未感染女性细胞学异常的危险因素，以及HIV感染女性宫颈上皮内瘤变（CIN）组织学诊断的危险因素。
方法包括对248例HIV感染女性的宫颈细胞学、阴道镜印象和组织学进行横断面分析，对253例HIV感染女性和220例未感染女性细胞学异常的危险因素以及186例HIV感染女性CIN的危险因素进行多变量分析。
所有CIN分级的细胞学检查敏感性和特异性分别为0.60和0.80，高级别CIN的敏感性和特异性分别为0.83和0.74。HIV感染女性细胞学异常的患病率为32.9%，HIV阴性女性为7.6%。细胞学异常的独立危险因素为免疫缺陷[比值比（OR）8 - 17，P < 0.001]和人乳头瘤病毒（HPV）感染（OR = 5，P < 0.001）。HIV感染女性CIN的组织学患病率为32%，CIN的唯一独立危险因素是致癌性HPV类型（OR = 5，P = 0.005）。
鉴于HIV感染女性细胞学异常和CIN的高患病率，细胞学筛查有显著局限性。免疫缺陷和HPV感染类型都是重要的危险因素。
