Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?
Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?
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人乳头瘤病毒的感染模式是否影响巴氏试验中高级别宫颈病变的细胞学检测？
DOI：
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发表时间：
2017
影响因子：
4.6
通讯作者：
Y. Ge
中科院分区：
文献类型：
--
作者：
Siavash Azadmanesh Samimi;Roxanne R. Mody;S. Goodman;Eric Luna;Donna Armylagos;M. Schwartz;D. Mody;Y. Ge
背景
- 高危型人乳头瘤病毒（hrHPV）持续感染是宫颈癌的主要原因。 HPV 感染模式对宫颈病变细胞学检测的影响尚不清楚。
目标
- 确定 HPV 感染模式对高级别宫颈病变细胞学检测敏感性的影响。
设计
- 对 257 名经活检证实患有高级鳞状上皮内病变的女性进行巴氏测试，分析其 HPV 感染模式。
结果
- 257例经活检证实的高度鳞状上皮内病变病例中，前述细胞学检查显示20例（8%）为良性； 166例（65%）为宫颈低度病变，包括意义不明的不典型鳞状细胞和低度鳞状上皮内病变； 71例（28%）为宫颈高度病变，其中不典型鳞状细胞不能排除高度鳞状上皮内病变（非典型鳞状细胞高）、非典型腺细胞、高度鳞状上皮内病变。在 236 例 HPV 检测中，细胞学表现出低度宫颈病变的患者通常与混合 hrHPV 基因型（40 例中的 31 例；78%）或非 16/18 hrHPV（75/103；73%）的混合感染有关，而与 HPV-16（62 例中的 33 例；53%）或 HPV-18（6 例中的 2 例；6 例中的 2 例）单基因型感染相比，这些病例通常与混合感染有关。 33%）（P = .001）。相反，与非 16/18 hrHPV（103 例中的 25 例；24%）或多基因型感染（40 例中的 8 例；20%）相比，高级别宫颈病变细胞形态学倾向于与 HPV-16（62 例中的 20 例；32%）或 HPV-18（6 例中的 3 例；50%）的单基因型感染相关（P = .01）。
结论
- 我们的研究结果表明，多基因型或非 16/18 hrHPV 感染通常会产生具有欺骗性的低级细胞形态学，这可能导致诊断不足和治疗延误。 HPV 感染模式可能会带来 HPV 基因分型之外的未被认识到的益处，在对细胞学级别较低的女性进行临床风险评估时应予以考虑。
CONTEXT
- Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown.
OBJECTIVE
- To determine the effect of HPV infection patterns on the sensitivity of cytologic detection of high-grade cervical lesions.
DESIGN
- Papanicolaou tests from 257 women with biopsy-confirmed, high-grade squamous intraepithelial lesions were analyzed with respect to HPV infection patterns.
RESULTS
- Among 257 biopsy-confirmed, high-grade squamous intraepithelial lesion cases, the preceding cytology showed 20 cases (8%) were benign; 166 cases (65%) were low-grade cervical lesions, including atypical squamous cell of undetermined significance and low-grade squamous intraepithelial lesions; and 71 cases (28%) were high-grade cervical lesions, including atypical squamous cells cannot rule out high-grade squamous intraepithelial lesion (atypical squamous cell-high), atypical glandular cells, and high-grade squamous intraepithelial lesions. In 236 cases tested for HPV, those exhibiting low-grade cervical lesions on cytology were often associated with coinfections of mixed hrHPV genotypes (31 of 40; 78%) or non-16/18 hrHPV (75/103; 73%), compared with single-genotype infections of HPV-16 (33 of 62; 53%) or HPV-18 (2 of 6; 33%) ( P = .001). In contrast, high-grade cervical lesion cytomorphology tended to associate with the single-genotype infection of HPV-16 (20 of 62; 32%) or HPV-18 (3 of 6; 50%), compared with non-16/18 hrHPV (25 of 103; 24%) or multigenotype infection (8 of 40; 20%) ( P = .01).
CONCLUSIONS
- Our findings suggest that multigenotypic or non-16/18 hrHPV infections often produce deceptive lower-grade cytomorphology, which could result in underdiagnosis and delay of treatment. The HPV infection patterns may offer unrecognized benefit beyond HPV genotyping and should be considered during clinical risk evaluation of women with lower-grade cytology.
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DOI：
10.1097/00006254-200010000-00016
发表时间：
2000-03
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
R. Herrero;A. Hildesheim;Concepcion Bratte;M. Sherman;M. Hutchinson;J. Morales;I. Balmaceda;M. Gre
通讯作者：
R. Herrero;A. Hildesheim;Concepcion Bratte;M. Sherman;M. Hutchinson;J. Morales;I. Balmaceda;M. Gre
影响因子：
6.4
作者：
Franco, EL;Villa, LL;Rohan, TE
通讯作者：
Rohan, TE
影响因子：
6.4
作者：
Plummer, Martyn;Schiffman, Mark;Wheeler, Cosette M.
通讯作者：
Wheeler, Cosette M.
影响因子：
6.4
作者：
Chaturvedi, Anil K.;Katki, Hormuzd A.;Herrero, Rolando
通讯作者：
Herrero, Rolando
影响因子：
3.5
作者：
Saslow, Debbie;Solomon, Diane;Myers, Evan R.
通讯作者：
Myers, Evan R.