Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-positive and HIV-negative women
Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-positive and HIV-negative women
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DOI：
10.1046/j.1365-2303.2001.00299.x
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发表时间：
2001-04-01
期刊：
影响因子：
1.3
通讯作者：
Syrjänen, K
中科院分区：
文献类型：
--
作者：
Branca, M;Rossi, E;Syrjänen, K
作为在意大利开展的广泛的多机构 DIANAIDS-HIV-HPV-SIL 项目（由 ISS 协调）的一部分，本研究比较了常规宫颈涂片细胞学检查与阴道镜检查在 37 名 HIV 阳性和 21 名 HIV 阴性女性（属于 DIANAIDS 队列的 459 名女性）中检测组织学确诊的 CIN 病变的性能（敏感性、特异性、一致性）。所有女性都接受了宫颈涂片、阴道镜检查和活组织检查，使这些技术的成对比较成为可能。在整个系列的HIV阳性和HIV阴性女性中，细胞学的敏感性为86.9%，特异性为83.3%，阴道镜2级异常对组织学的敏感性为82.6%，特异性为33.3%。 HIV 阳性和 HIV 阴性女性之间的子宫颈抹片检查结果没有观察到统计学上的显着差异。细胞学的敏感性为89.7% vs 82.4%，特异性为75% vs 100%。对于阴道镜检查，敏感性为 79.3% vs 88.2%，特异性为 75% vs 50%。这些数据表明，宫颈巴氏涂片细胞学检查是临床监测 HIV 阳性女性下生殖道病理的高度敏感性和特异性的诊断工具。另一方面，事实证明，阴道镜检查对于这些女性来说是一种不太准确的诊断工具。
As part of an extensive multi-institutional DIANAIDS-HIV-HPV-SIL project run in Italy (co-ordinated by ISS), the present study compares the performance (sensitivity, specificity, agreement) of routine cervical smear cytology with that of colposcopy in the detection of histologically-confirmed CIN lesions in 37 HIV-positive and 21 HIV-negative women, belonging to the DIANAIDS cohort of 459 women. All women were subjected to a cervical smear, colposcopy and biopsy, making possible the pairwise comparison of these techniques. In the whole series of HIV-positive and HIV-negative women, cytology had a sensitivity of 86.9% and specificity of 83.3%, the sensitivity of grade 2 abnormality on colposcopy against histology being 82.6% and specificity, 33.3%. No statistically significant difference was observed in the performance of Pap smears between the HIV-positive and HIV-negative women. The sensitivity of cytology was 89.7% vs 82.4% and the specificity, 75% vs 100%. For colposcopy, the sensitivity was 79.3% vs 88.2% and the specificity, 75% vs 50%, These data suggest that cervical Pap smear cytology is a highly sensitive and specific diagnostic tool in the clinical monitoring of lower genital tract pathology in HIV-positive women. Colposcopy, on the other hand, proved to be a somewhat less accurate diagnostic tool in these women.