Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion.
Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion.
复制标题
人乳头瘤病毒在低度鳞状上皮内病变细胞学亚组中的分布比较。
作者：
Zuna,RosemaryE;Wang,SophiaS;Schiffman,Mark;Solomon,Diane
低级别鳞状上皮内病变（LSIL）包括以前描述的细胞学类别人乳头瘤病毒（HPV）相关细胞变化（挖空细胞性宫颈炎）和低级别异型增生/宫颈上皮内瘤样病变（CIN）1级（CIN 1）。在这项研究中，目的是确定这2种形态学亚类是否以CIN 3和/或HPV类型分布的风险差异为特征。方法在意义不明的非典型鳞状细胞/低度鳞状上皮内病变分类研究中，对转诊巴氏（Pap）试验或入组ThinPrep® Pap试验的所有受试者（社区实验室、临床中心或病理学质量控制组）进行分析。HPV检测通过Hybrid Capture™ 2（HC 2）和基于聚合酶链反应的27种HPV类型的反向线印迹分析进行。计算了2年随访期间各种细胞学解释的累积检出CIN 3或癌症（CIN 3+）和CIN 2或更严重（CIN 2+）的绝对风险。对于每个审查组和细胞学制备，大多数LSIL解释（从大约3种解释中的2种到4种解释中的3种）被亚分类为CIN 1而不是HPV细胞变化。HPV 16型（HPV-16）是最常见的HPV类型，在21%至24%的CIN 1和14%至18%的HPV细胞变化中鉴定。非致癌类型仅在9%至11%的CIN 1中确定，而HPV细胞变化为17%至20%。累积检测到的CIN 3+中，CIN 1和HPV细胞变化的绝对风险范围为CIN 1的12%至16%，HPV细胞变化的6%至9%。结论LSIL的两个细胞学亚类主要与致癌HPV类型相关;然而，与HPV细胞变化相比，非致癌HPV类型的比例较低，CIN 3+的绝对风险高于CIN 1。LSIL亚分类的一致性较低，作者得出结论，诊断区分对于个体患者管理的临床效用有限。癌症（癌症细胞病理学）2006年由美国癌症协会出版。
BACKGROUNDLow‐grade squamous intraepithelial lesion (LSIL) subsumes the formerly delineated cytologic categories of human papillomavirus (HPV)‐associated cell changes (koilocytotic atypia) and low‐grade dysplasia/cervical intraepithelial neoplasia (CIN) Grade 1 (CIN1). In this study, the objective was to determine whether these 2 morphologic subcategories are characterized by differences in risk for CIN3 and/or HPV type distribution.METHODSWithin the Atypical Squamous Cells of Undetermined Significance/Low‐Grade Squamous Intraepithelial Lesion Triage Study, all cytologic interpretations of HPV cellular changes and CIN1 rendered by any of the pathology reviewers (community laboratory, clinical center, or Pathology Quality‐Control Group) on referral Papanicolaou (Pap) tests or enrollment ThinPrep® Pap tests were included for analysis. HPV testing was performed by Hybrid Capture™ 2 (HC2) and by polymerase chain reaction based reverse‐line blot analysis for 27 HPV types. The absolute risks of cumulative detection of CIN3 or cancer (CIN3 +) and CIN2 or worse (CIN2 +) over 2 years of follow‐up were calculated for the various cytologic interpretations.RESULTSFor each review group and cytology preparation, most LSIL interpretations (from approximately 2 of 3 interpretations to 3 of 4 interpretations) were subcategorized as CIN1 rather than HPV cellular changes. HPV type 16 (HPV‐16) was the most common HPV type and was identified in 21% to 24% of CIN1 and in 14% to 18% of HPV cellular changes. Nononcogenic types were identified alone in from 9% to 11% of CIN1 compared with 17% to 20% of HPV cellular change. The absolute risks of CIN1 and HPV cellular changes for cumulatively detected CIN3 + ranged from 12% to 16% for CIN1 and from 6% to 9% for HPV cellular changes.CONCLUSIONSBoth cytologic subcategories of LSIL were associated predominantly with oncogenic HPV types; however, the proportion of nononcogenic HPV types was lower and the absolute risks for CIN3 + were higher for CIN1 compared with HPV cellular changes. The concordance in subcategorizing LSIL was low, and the authors concluded that the diagnostic distinction is of limited clinical utility for individual patient management. Cancer (Cancer Cytopathol) 2006 Published 2006 by the American Cancer Society.