Prevalence, risk factors, and accuracy of cytologic screening for cervical intraepithelial neoplasia in women with the human immunodeficiency virus
Prevalence, risk factors, and accuracy of cytologic screening for cervical intraepithelial neoplasia in women with the human immunodeficiency virus
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DOI：
10.1006/gyno.1998.4938
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发表时间：
1998-03-01
影响因子：
4.7
通讯作者：
Minkoff, H
中科院分区：
文献类型：
--
作者：
Maiman, M;Fruchter, RG;Minkoff, H
目标。目的是评估感染人类免疫缺陷病毒（HIV）的女性宫颈细胞学检查的敏感性和特异性、HIV感染者和未感染者细胞学异常的危险因素，以及HIV感染者宫颈上皮内瘤变（CIN）组织学诊断的危险因素。方法。方法包括对 248 名 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，并对 253 名 HIV 感染者和 220 名未感染女性的细胞学异常危险因素以及 186 名 HIV 感染女性的 CIN 危险因素进行多变量分析。 结果。所有 CIN 级别的细胞学敏感性和特异性分别为 0.60 和 0.80，对于高级别 GIN，细胞学敏感性和特异性分别为 0.83 和 0.74。 HIV感染者和HIV阴性女性中细胞学异常的患病率为32.9%和7.6%。细胞学异常的独立危险因素是免疫缺陷[优势比（OR）8-17，P < 0.001]和人乳头瘤病毒（HPV）感染（OR = 5，P < 0.001）。 HIV感染女性中CIN的组织学患病率为32%，CIN的唯一独立危险因素是致癌HPV类型（OR = 5，P = 0.005）。结论。鉴于 HIV 感染女性中细胞学异常和 CIN 的患病率很高，细胞学筛查具有很大的局限性。免疫缺陷和 HPV 感染类型都是重要的危险因素。 (C) 1998 年学术出版社。
Objectives. 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. 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.Results. The sensitivity and specificity of cytology for all CIN grades were 0.60 and 0.80 and, for high-grade GIN, 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).Conclusion. 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. (C) 1998 Academic Press.