HUMAN PAPILLOMAVIRUS TESTING BY HYBRID CAPTURE APPEARS TO BE USEFUL IN TRIAGING WOMEN WITH A CYTOLOGIC DIAGNOSIS OF ATYPICAL SQUAMOUS CELLS OF UNDETERMINED SIGNIFICANCE
HUMAN PAPILLOMAVIRUS TESTING BY HYBRID CAPTURE APPEARS TO BE USEFUL IN TRIAGING WOMEN WITH A CYTOLOGIC DIAGNOSIS OF ATYPICAL SQUAMOUS CELLS OF UNDETERMINED SIGNIFICANCE
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DOI：
10.1016/0002-9378(95)90026-8
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发表时间：
1995-03-01
影响因子：
9.8
通讯作者：
KURMAN, RJ
中科院分区：
文献类型：
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作者：
COX, JT;LORINCZ, AT;KURMAN, RJ
目的：我们的目的是通过杂交捕获试验确定人乳头瘤病毒脱氧核糖核酸检测的临床价值，特别是检查人乳头瘤病毒检测是否可以识别哪些Papanicolaou涂片读取为意义不明的非典型鳞状细胞的妇女最有可能患有组织学证实的宫颈上皮内瘤变。研究设计：对217名到学生阴道镜诊所就诊的女性同时进行了14种人乳头瘤病毒类型的混合捕获试验、重复帕帕尼科拉乌涂片和阴道镜指导下的活检，这些女性先前的帕帕尼科拉乌涂片被认为是意义不明的非典型鳞状细胞。结果：人乳头瘤病毒脱氧核糖核酸阳性与宫颈上皮内瘤变组织学证实的可能性增加8倍相关。杂交捕获对任何宫颈上皮内瘤变的敏感性为86%(43/50)，对2级或3级瘤变的敏感性为93%(14/15)，而重复巴氏涂片的相应值分别为60%（30/50）和73%（11/15）。此外，已知与宫颈癌相关的人乳头瘤病毒类型的高病毒水平强烈预测或高度宫颈上皮内瘤变。结论：混合捕获检测人乳头瘤病毒脱氧核糖核酸似乎提供了一种有效的方法，通过这种方法，宫颈巴氏涂片被认为是意义不明的非典型鳞状细胞的患者可以进行阴道镜检查。特别是，仅参考那些癌症相关病毒类型的人乳头瘤病毒脱氧核糖核酸水平升高的患者，可以保持对高级别宫颈上皮内瘤变的敏感性，并显着提高特异性。
OBJECTIVE: Our purpose was to determine the clinical value of human papillomavirus deoxyribonucleic acid testing with the hybrid capture test, specifically to examine whether human papillomavirus testing could identify which women with Papanicolaou smears read as atypical squamous cells of undetermined significance were most likely to have histologically confirmed cervical intraepithelial neoplasia.STUDY DESIGN: Hybrid capture testing for 14 human papillomavirus types, repeat Papanicolaou smears, and colposcopically directed biopsies were performed concurrently on 217 women referred to a student health colposcopy clinic with a previous Papanicolaou smear read as atypical squamous cells of undetermined significance.RESULTS: Human papillomavirus deoxyribonucleic acid positivity was associated with an eightfold increased likelihood of histologic confirmation of cervical intraepithelial neoplasia. The sensitivity of hybrid capture for any cervical intraepithelial neoplasia was 86% (43/50) and for grade 2 or 3 was 93% (14/15), whereas the corresponding values for the repeat Papanicolaou smear were 60% (30/50) and 73% (11/15), respectively. Moreover, high viral levels of human papillomavirus types known to be associated with cervical cancer were strongly predictive or high-grade cervical intraepithelial neoplasia.CONCLUSION'S: Testing for human papillomavirus deoxyribonucleic acid with hybrid capture appears to offer an effective means by which patients whose cervical Papanicolaou smears have been read as atypical squamous cells of undetermined significance could be triaged for colposcopy. In particular, sensitivity for high-grade cervical intraepithelial neoplasia could be maintained and specificity markedly improved by referring only those patients who had elevated levels of human papillomavirus deoxyribonucleic acid of cancer-associated viral types.