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首页> 外文期刊>Journal of lower genital tract disease. >Risk of cervical precancer and cancer in women aged 30 years and older with an HPV-negative low-grade squamous intraepithelial lesion screening result.
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Risk of cervical precancer and cancer in women aged 30 years and older with an HPV-negative low-grade squamous intraepithelial lesion screening result.

机译：HPV阴性低级鳞状上皮内病变筛查结果在30岁及30岁以上的女性中罹患宫颈癌的风险。

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OBJECTIVE: To characterize the 6- and 18-month cumulative risk of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+) in women aged 30 years and older after a low-grade squamous intraepithelial lesion (LSIL) cytology and high-risk human papillomavirus (HPV)-negative screening result in routine clinical practice. MATERIALS AND METHODS: Comprehensive quality assurance databases of screening test and biopsy results from the Regional Laboratory of the Kaiser Permanente Northern California Health Plan were reviewed. All women aged 30 years and older with LSIL cytology were sorted by high-risk HPV status. Associated biopsy results were tabulated, and the corresponding risks of CIN 2+ and CIN 3+ diagnosed within 18 months after LSIL cytology were calculated overall and by decade of age. RESULTS: During the 6-year period, from 2003 to 2008, 4,113 LSIL cases were interpreted in women aged 30 years and older for which corresponding high-risk HPV and biopsy results were available. The proportion of women with LSIL testing positive for HPV declined with age, from 89% in the group aged 30 to 39 years to 76% in women older than 50 years (p < .001). Of 622 women with HPV-negative LSIL cytology, there was no case of cancer detected at colposcopy occurring within 6 months of the screening test. The 18-month risks of CIN 2+ and CIN 3+ were 3.5% and 1.4%, respectively. CONCLUSIONS: The risk of CIN 3+ is sufficiently low in women aged 30 years and older with high-risk HPV-negative LSIL that 1 year follow-up rather than immediate colposcopy should be considered when it occurs in routine clinical practice.
机译：目的：研究低度鳞状上皮内瘤变后30岁及30岁以上女性宫颈上皮内瘤变的2个月或更严重（CIN 2+）和3级或更严重（CIN 3+）在6个月和18个月的累积风险。病灶（LSIL）细胞学检查和高危人乳头瘤病毒（HPV）阴性筛查可导致常规临床实践。材料与方法：审查了来自北加州凯泽永久健康计划区域实验室的筛查测试和活检结果的综合质量保证数据库。所有30岁及以上具有LSIL细胞学检查的妇女均按高危HPV状况分类。将相关的活检结果制成表格，并按年龄和十岁年龄计算LSIL细胞学检查后18个月内诊断出CIN 2+和CIN 3+的相应风险。结果：在2003年至2008年的6年中，对30岁及30岁以上的女性进行了4113例LSIL病例的解释，因此可获得相应的高危HPV和活检结果。 LSIL检测为HPV阳性的女性比例随着年龄的增长而下降，从30岁至39岁年龄组的89％降至50岁以上女性的76％（p <.001）。在622例HPV阴性LSIL细胞学检查的女性中，没有在筛查试验的6个月内通过阴道镜检查发现癌症。 CIN 2+和CIN 3+的18个月风险分别为3.5％和1.4％。结论：对于30岁及以上高危HPV阴性LSIL的30岁以上女性，CIN 3+的风险足够低，因此在常规临床实践中应考虑随访1年而不是立即进行阴道镜检查。

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