- 期刊
Papanicolaou Smear and HPV Testing for Cervical Screening
人類乳突瘤病毒檢測合併傳統抹片在婦女子宮頸篩檢的應用
摘要
Background. Since the adequacy of screening for pre-cancer and cervical cancer with Papanicolaou (Pap) smear alone has been questioned, a number of adjunctive tests have been evaluated. This study determined whether human papillomavirus (HPV) testing can improve cervical screening when performed coincident with cytologic sampling. Methods. Patients were evaluated by Pap smear, HPV testing, and colposcopy at two study centers. Screening with either Pap smear alone or in combination with HPV testing (Pap and HPV testing) was evaluated by colposcopy-directed biopsy as the highest diagnostic standard. Results. The Pap smear alone detected 8/27 (29.6%) cases of women with significant pathology (precancerous lesion and HPV infection) on biopsy, whereas the combination of Pap and HPV testing detected 24/27(88.8%) cases. (p ＜ 0.001). Patients for whom both test results were normal (negative Pap and HPV testing) were extremely unlikely to harbor significant pathology (less than 1% of those screened). Pap smear and HPV testing together was especially helpful in the detection of low- grade cervical lesions compared to the detection rate with Pap smear alone. Conclusions. These data indicate that HPV testing combined with Pap smear exam increases the accuracy of cervical screening. HPV testing appears to be particularly useful as a triage instrument in women with otherwise negative Pap smears. Further studies to evaluate the cost effectiveness of this combined screening protocol are needed. (Mid Taiwan J Med 2002;7:21-7)
並列摘要
Background. Since the adequacy of screening for pre-cancer and cervical cancer with Papanicolaou (Pap) smear alone has been questioned, a number of adjunctive tests have been evaluated. This study determined whether human papillomavirus (HPV) testing can improve cervical screening when performed coincident with cytologic sampling. Methods. Patients were evaluated by Pap smear, HPV testing, and colposcopy at two study centers. Screening with either Pap smear alone or in combination with HPV testing (Pap and HPV testing) was evaluated by colposcopy-directed biopsy as the highest diagnostic standard. Results. The Pap smear alone detected 8/27 (29.6%) cases of women with significant pathology (precancerous lesion and HPV infection) on biopsy, whereas the combination of Pap and HPV testing detected 24/27(88.8%) cases. (p ＜ 0.001). Patients for whom both test results were normal (negative Pap and HPV testing) were extremely unlikely to harbor significant pathology (less than 1% of those screened). Pap smear and HPV testing together was especially helpful in the detection of low- grade cervical lesions compared to the detection rate with Pap smear alone. Conclusions. These data indicate that HPV testing combined with Pap smear exam increases the accuracy of cervical screening. HPV testing appears to be particularly useful as a triage instrument in women with otherwise negative Pap smears. Further studies to evaluate the cost effectiveness of this combined screening protocol are needed. (Mid Taiwan J Med 2002;7:21-7)
延伸閱讀
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- Ho, C. M. (2008). 就人類乳突病毒型別、病毒量和其嵌入宿主細胞狀態探討臺灣婦女子宮頸癌之致癌機轉 [doctoral dissertation, Taipei Medical University]. Airiti Library. https://doi.org/10.6831/TMU.2008.00053
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