在癌查中进行PAP-HPV联合测试:意大利的经验
Luigi Pisano1, Claudia Giachini2, Martina Turco1
1Section of Dermatology, Health Sciences Department, University of Florence, 50121 Florence, Italy.
Journal of clinical medicine
|April 12, 2025
概括
同时测试门细胞学和高危人乳头瘤病毒 (HR-HPV) 测试提供了优越的门病变高度查与单个测试相比. 这种综合方法对于风险人群的早期检测和预防至关重要.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
背景情况:
- 门状细胞癌 (SCCA) 与高风险的人类乳头瘤病毒 (HR-HPV) 感染有关,全球发病率不断增加.
- 细胞学和HR-HPV测试可以检测SCCA前体,但缺乏标准化查指南.
- 高分辨率异视镜 (HRA) 是内皮质瘤 (AIN) 的关键诊断工具.
研究的目的:
- 通过PAP-HPV联合测试,评估高分辨率异视镜 (HRA) 发现与初级查结果之间的相关性.
- 评估内细胞学,HR-HPV测试和PAP-HPV联合测试的诊断性能,以检测高度内病变 (AIN2+).
- 确定最佳查策略,以便在高风险人群中早期检测癌前体.
主要方法:
- 追溯性,单中心研究,分析来自联合多学科门癌症诊所 (2019年8月 - 2022年9月) 的数据.
- 评估敏感性,特异性,正预测值 (PPV),负预测值 (NPV) 和门细胞学,HR-HPV测试和PAP-HPV联合测试的准确性.
- 包括577名接受HRA的高风险患者,具有组织学相关性.
主要成果:
- 同时测试表明100%的灵敏度和100%的负预测值 (NPV) 高度内皮质瘤 (AIN2+).
- 分析细胞学显示,AIN2+病变的灵敏度为74.2%,特异性为63.3%.
- 仅HR-HPV测试对AIN2+病变具有96.8%的灵敏度和38.1%的特异性.
结论:
- PAP-HPV联合测试是对高度门病变 (AIN2+) 的最可靠的查方法,其性能优于单个测试.
- 量身定制的联合测试策略对于高风险患者群体中SCCA的有效早期检测和预防至关重要.
- 在与男性发生性关系的HIV阳性和HIV阴性男性 (MSM) 之间没有观察到显著的结果差异.
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