A Retrospective Analysis of 1151 Chinese Women With Atypical Glandular Cells: Impact of High-Risk Human Papilloma Virus Status and Age on Cervical and Endometrial Neoplasia Risk.

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Ruhang Fan, Shuang Song, Haiyan Shi, Xiaofei Zhang, Bingjian Lu
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Abstract

Objective: To investigate the clinical significance of high-risk human papillomavirus (hrHPV) testing and age in women with atypical glandular cells (AGC) on Pap tests.

Methods: We retrospectively analyzed the relationship between hrHPV and cytology co-testing, follow-up histopathology within 6 months, age, and other demographic features in a large cohort of AGC patients from a single Chinese academic institution.

Results: Among1510 AGC patients, 1151, 1260, and 866 patients had histopathologic results, hrHPV co-testing, and both, respectively. High-grade squamous intraepithelial lesions (HSIL)/adenocarcinoma in situ (AIS) and worse lesions (HSIL/AIS+) and endometrial atypical hyperplasia (EAH)/endometrial carcinoma (EC) (EAH/EC+) were present in 27.8% (281/1009) and 25.1% (113/450) patients, respectively. hrHPV was positive in 34.5% (435/1260) patients. Among hrHPV+ patients with genotyping by the Aptima assay, 48.8% (125/256) had HPV16 and/or 18/45. Compared to hrHPV- patients, hrHPV+ women had a significantly increased risk of HSIL/AIS+ (OR: 10.958, 95% CI: 7.657-15.682), particularly with HPV16 and/or18/45 (OR: 3.556, 95% CI: 2.122-5.959; both p < 0.001). Among hrHPV- patients, those aged ≥ 40 years had higher risks of HSIL/AIS+ (including 18 HPV-independent and 11 metastatic adenocarcinomas; OR: 5.882, 95% CI: 2.702-12.806) and EAH/EC+ (OR: 7.622, 95% CI: 3.188-18.225) compared to younger patients (both p < 0.001).

Conclusions: Combining hrHPV testing and age effectively stratifies risks in AGC patients: hrHPV positivity predicts high-grade cervical lesions, while older hrHPV-negative women are more likely to have endometrial or extra-uterine malignancies. These findings may optimize management of AGC patients with cumulative supportive data.

1151例中国非典型腺细胞女性的回顾性分析:高危人乳头瘤病毒状态和年龄对宫颈和子宫内膜瘤风险的影响
目的:探讨巴氏涂片检查非典型腺细胞(AGC)女性中高危人乳头瘤病毒(hrHPV)检测及年龄的临床意义。方法:我们回顾性分析了hrHPV与细胞学联合检测、6个月内随访组织病理学、年龄和其他人口统计学特征之间的关系,这些数据来自中国一家学术机构的AGC患者。结果:在1510例AGC患者中,分别有1151例、1260例和866例患者有组织病理学结果、hrHPV联合检测和两者兼有。27.8%(281/1009)和25.1%(113/450)患者分别存在高级别鳞状上皮内病变(HSIL)/原位腺癌(AIS)和更严重病变(HSIL/AIS+)和子宫内膜不典型增生(EAH)/子宫内膜癌(EC) (EAH/EC+)。hrHPV阳性34.5%(435/1260)。在通过Aptima检测进行基因分型的hrHPV+患者中,48.8%(125/256)的HPV16和/或18/45。与hrHPV-患者相比,hrHPV+女性HSIL/AIS+的风险显著增加(OR: 10.958, 95% CI: 7.657-15.682),特别是HPV16和/or18/45 (OR: 3.556, 95% CI: 2.222 -5.959;结论:hrHPV检测与年龄相结合可有效分层AGC患者的风险:hrHPV阳性预测宫颈高级别病变,而年龄较大的hrHPV阴性妇女更容易发生子宫内膜或子宫外恶性肿瘤。这些发现可能会优化AGC患者的管理累积支持数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
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