Does the interval between papanicolaou tests influence the quality of cytology?
Does the interval between papanicolaou tests influence the quality of cytology?
复制标题
巴氏试验之间的间隔是否会影响细胞学的质量？
作者：
Jeronimo,Jose;Khan,MichelleJ;Schiffman,Mark;Solomon,Diane;ALTSGroup
背景通常认为巴氏试验(Pap)的敏感度随着细胞学采样间隔的缩短而降低。据作者所知，只有有限的证据支持这一观点。方法在5055名妇女中，在未确定意义的非典型鳞状细胞(ASCUS)-低度鳞状上皮内病变(ALTS)分类研究中，巴氏间隔被定义为转诊巴氏涂片显示ASCUS或LSIL(“第一细胞学”)和登记液体为基础(“重复”)细胞学之间的天数。作者调查了巴氏涂片间隔时间对重复细胞学检查的影响，方法是在ALTTS的两年病程中，检查诊断为宫颈上皮内瘤变(CIN3)的组织学分级为3级的妇女的异常发现、细胞密度和检测敏感性的百分比。此外，由于目前正在进行人乳头状瘤病毒(HPV)DNA辅助检测，作者对患有CIN3的妇女进行了HPV病毒载量的评估，并使用残液细胞学标本进行了检测。结果763名妇女的Pap间期为8-30天，2317名妇女为31-60天，1090名妇女为61-90天，491名妇女为91-120天，394名妇女为121-184天(平均61.3天；标准差为34天)。对不满意的发现、ASCUS和高度鳞状上皮内病变(HSIL)的重复细胞学解释在巴氏间期组之间似乎没有差异。但随着PAP间期的延长，细胞学低度退化，细胞学转阴率从28.3%(8~30天)增加到41.6%(121~184d)(P<；0.0001)，而Lsil细胞学下降(P趋势=0.002)。间隔8~30d组样品的近似细胞密度稍好(P趋势=0.04)。在患有CIN3的妇女中，在ASCUS或更高阈值下的重复检测灵敏度和HPV DNA病毒载量没有发现随着巴氏间隔的变化(分别为Ptrend=0.80和Ptrend=0.36)。结论作者得出结论，较短的巴氏间隔(范围为15-120天)不会显著影响液基重复细胞学的质量，也不会显著影响从残留液基标本中检测的病毒载量。癌症(癌症细胞病理学)2005年。由美国癌症协会于2005年发表。
BACKGROUNDIt is commonly believed that the sensitivity of Papanicolaou (Pap) tests decreases with a short interval between cytology samplings. To the authors' knowledge, there is only limited evidence to support this belief.METHODSFor 5055 women in the Atypical Squamous Cells of Undetermined Significance (ASCUS)–Low Grade Squamous Intraepithelial Lesion (LSIL) Triage Study (ALTS), the Pap interval was defined as the number of days between the referral Pap smear demonstrating ASCUS or LSIL (“first cytology”) and the enrollment liquid‐based (“repeat”) cytology. The authors investigated the influence of the interval between Pap smears on repeat cytology by examining percentages of abnormal findings, cellularity, and test sensitivity among women diagnosed with histologic grade 3 cervical intraepithelial neoplasia (CIN3) during the 2‐year course of the ALTS. In addition, because human papillomavirus (HPV) DNA adjunct testing is now performed, the authors evaluated HPV viral load, which was assayed using residual liquid cytology specimens, in women with CIN3.RESULTSThe Pap interval ranged from 8–30 days in 763 women, 31–60 days in 2317 women, 61–90 days in 1090 women, 91–120 days in 491 women, and 121–184 days in 394 women (mean of 61.3 days; standard deviation of 34 days). Repeat cytologic interpretations of unsatisfactory findings, ASCUS, and high‐grade squamous intraepithelial lesion (HSIL) did not appear to vary among the Pap interval groups. However, low‐grade cytologic regression occurred with an increasing Pap interval; negative cytology increased from 28.3% (8–30 days) to 41.6% (121–184 days) (P< 0.0001) whereas LSIL cytology decreased (Ptrend = 0.002). The approximate cellularity of the samples was slightly better in the interval group of 8–30 days (Ptrend = 0.04). Among women with CIN3, the repeat test sensitivity at a threshold of ASCUS or greater and the HPV DNA viral load was not found to vary by Pap interval (Ptrend = 0.80 andPtrend = 0.36, respectively).CONCLUSIONSThe authors concluded that a short Pap interval (range, 15–120 days) does not significantly affect the quality of liquid‐based repeat cytology, nor the viral load tested from a residual liquid‐based specimen. Cancer (Cancer Cytopathol) 2005. Published 2005 by the American Cancer Society.