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Follow-up Outcomes in a Large Cohort of Patients With HPV-Negative LSIL Cervical Screening Test Results.

HPV阴性、宫颈筛查LSIL患者的大宗随访结果

Barron S,Austin RM,Li Z,Zhao C

Abstract

Cervical screening guidelines now recommend repeat cotesting of patients aged 30 years and older having a human papillomavirus (HPV)-negative low-grade squamous intraepithelial lesion (LSIL) in 1 year as preferred management. Only limited follow-up data on patients with HPV-negative LSILs are available from routine US clinical practice settings.
In total, 680 patients with Hybrid Capture 2 (Qiagen, Hinden, Germany) high-risk HPV-negative LSIL ThinPrep (Hologic, Marlborough, MA) results were identified. Patients' ages and histopathologic, cytologic, and HPV follow-up results were identified.
Among 680 patients with HPV-negative LSILs, 468 had follow-up within 1 year. During the study period, 14 (3.0%) of 468 had follow-up high-grade squamous intraepithelial lesion (HSIL) and 184 (39.3%) LSIL findings. No diagnoses of cervical carcinoma were documented. There were no significant follow-up differences between age groups. Of the 321 patients who had follow-up HPV testing, 271 (84.4%) had negative and 50 (15.6%) had positive HPV results.
This is the largest study documenting follow-up results for patients with HPV-negative LSIL results based on prevalent US FDA-approved cotesting methods from one collection vial. These data document that risk for follow-up HSILs in these patients is low and also that no cervical cancers were diagnosed. These findings support recent recommendations for repeat cotesting after 1 year as an appropriate option for patients with HPV-negative LSIL results.

摘要

对于30岁以上的人乳头瘤病毒(HPV)阴性低度鳞状上皮内病变(LSIL)患者,目前的宫颈筛查指南推荐一年内重复联合检查作为优选管理。来自美国日常临床实践的HPV阴性LSIL患者仅有有限的随访数据。

共有680名患者通过第2代杂交捕获技术(Qiagen, Hinden, Germany)和ThinPrep液基细胞学(Hologic, Marlborough, MA)发现了高危型HPV阴性的LSIL。收集患者的年龄以及组织学、细胞学和HPV随访结果。

在680名HPV阴性LSIL患者中,在1年内随访了468名。在这1年中,14/468 (3.0%)名随访发现高度鳞状上皮内病变(HSIL),184 (39.3%)名发现LSIL。未发现宫颈癌。各年龄组之间无显着的随访差异。321名患者随访了HPV检测,其中271 (84.4%)名为HPV 阴性,50 (15.6%)名为HPV 阳性。 这是根据当前美国FDA批准的联合检查方法对小范围人群进行的HPV阴性LSIL的最大宗的随访研究。这些数据表明,这些患者中随访发现HSIL的风险低,也没有发现宫颈癌。对于HPV阴性LSIL,这些发现支持最近推荐的1年后重复联合检查是恰当的选择。

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