广泛的HPV基因分型对非典型腺细胞女性宫颈高级肿瘤的重要性
The significance of extensive HPV genotyping for cervical high-grade neoplasia among women with atypical glandular cells
影响因子:1.90000
分区:医学4区 / 病理学3区
发表日期:2025 Jan 28
作者:
Xiao Tang, Megan L Zilla, Wei Jiang, Yanmei He, David Starr, Lei Li, Lingling Tong, Cheng Wang, Wei Wang, Kaixuan Yang, Rutie Yin, Chengquan Zhao
摘要
检查AGC和广泛的人乳头瘤病毒（HPV）基因型患者的颈椎上皮内肿瘤3（CIN3）病变的相关风险。与非典型腺细胞（AGC）解释相关的PapanicolaOU（PAP）测试的cassecase。 469,694个PAP测试，0.4％被诊断为AGC。总共有1267例同时具有高风险HPV（HRHPV）基因分型，而HRHPV呈阳性40.3％。当HRHPV阳性时，宫颈CIN3在组织学随访中的AGC病例百分比为52.2％，而HRHPV负面的HRHPV为4.9％。该队列中与宫颈CIN3相关的前5个HRHPV基因型是HPV16，HPV18，HPV58，HPV52和HPV33。实际上，该队列中发现的HRHPV相关的CIN3病变中有92.8％对这些HPV基因型中的至少一种是阳性的。在其中包括额外的12个基因型时，检测宫颈CIN3病变的敏感性为85.6％（HPV16/18/58/52/33），仅包括其他12个基因型的患者。和/或33。将全面的HPV基因分型纳入AGC细胞学允许进行精致的风险分层和更量身定制的管理策略。版权所有。有关商业重复使用，请联系reprints@oup.com，以获取转载和翻译权以进行转载。所有其他权限都可以通过我们的restrimlink服务通过我们网站上文章页面上的“权限链接”获得 - 有关更多信息，请联系journals.permissions.permissions@oup.com。
Abstract
To examine the associated risk of cervical intraepithelial neoplasm grade 3+ (CIN3+) lesions in patients with AGC and extensive human papillomavirus (HPV) genotyping.Cases with atypical glandular cell (AGC) interpretation on a Papanicolaou (Pap) test were identified along with associated extensive HPV genotyping and histologic follow-up results.Within this cohort of 469,694 Pap tests, 0.4% were diagnosed as AGCs. In total, 1267 cases had concurrent high-risk HPV (hrHPV) genotyping, and 40.3% were hrHPV positive. The percentage of AGC cases with cervical CIN3+ on histologic follow-up was 52.2% when hrHPV was positive, whereas it was 4.9% with a negative hrHPV result. The top 5 hrHPV genotypes associated with cervical CIN3+ in this cohort were HPV16, HPV18, HPV58, HPV52, and HPV33. Indeed, 92.8% of the hrHPV-associated CIN3+ lesions identified in this cohort were positive for at least one of these HPV genotypes. The sensitivity of detecting cervical CIN3+ lesions was 85.6% with the top 5 hrHPV genotypes (HPV16/18/58/52/33) and only increased to 89.0% when the additional 12 genotypes were included.In patients with an AGC Pap, the risk of having a cervical CIN3+ lesion is greatly increased by positivity for hrHPV types 16, 18, 58, 52, and/or 33. Incorporating comprehensive HPV genotyping into AGC cytology allows for refined risk stratification and more tailored management strategies.© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.