Three Years of Co-Testing 2020-2022: Correlation of Diagnostic Colposcopy with Histology in Cases of Normal Cytology and Persistent High-Risk HPV.

IF 2.6 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Geburtshilfe Und Frauenheilkunde Pub Date : 2026-06-22 eCollection Date: 2026-08-01 DOI:10.1055/a-2871-3304

Arjola Xhaja, André Ahr, Ilona Zeiser

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引用次数: 0

Abstract

Introduction: Since the introduction of organised cervical cancer screening, abnormal findings have been referred for diagnostic colposcopy in accordance with defined algorithms. The algorithms are primarily based on the HPV test results. A colposcopy is recommended even in cases where the cytology is normal but HPV persists. CIN2+ lesions are also detected in the process. The aim of this study is to investigate the causes of normal cytological results followed by CIN2+ lesions.

Patients and methods: All cytological, HPV, and resultant histological test results from the primary screening, recorded in our database between 2020 and 2022, were analysed. The CIN2+ lesions with normal cytology were re-evaluated with regard to the quality of the cell material.

Results: A total of 884201 preventive cytology tests and 5002 corresponding histology results from the years 2020-2022 were evaluated. In the normal groups I/II-a, 49 CIN2+ lesions were documented. After revision, 71% (35 cases) remained in group I/II-a. The revision resulted in 16% (8 cases) being reclassified into group 0, and in 12% (6 cases) showing minor discrepancies.

Conclusion: Due to the persistence of high-risk HPV, CIN2+ lesions were diagnosed via colposcopy and biopsy despite normal cytology results. These lesions account for a small proportion of the total population. The main reason for the discrepancy was that the cell material was difficult to assess. In the majority of cases where discrepancies were found, but the cell material was otherwise easy to assess, dysplastic cells were absent. This shows that the real problem here lies in the pre-analytical stage. It is possible that the dysplastic areas may not be reached during the swab collection. Systematic reporting of specimen quality and a separate category for HPV-positive/cytologically unremarkable findings in MN III could improve diagnostic management.

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三年联合检测2020-2022：正常细胞学和持续性高危HPV病例中诊断性阴道镜与组织学的相关性

引言：自从引入有组织的宫颈癌筛查以来，异常发现已根据定义的算法转介进行阴道镜诊断。该算法主要基于HPV检测结果。即使在细胞学正常但HPV持续存在的情况下，也建议进行阴道镜检查。在此过程中也可检出CIN2+病变。本研究的目的是探讨正常细胞学结果随后出现CIN2+病变的原因。患者和方法：我们分析了在2020年至2022年期间记录在我们数据库中的初级筛查的所有细胞学、HPV和由此产生的组织学检查结果。细胞学正常的CIN2+病变重新评估细胞材料的质量。结果：共评估2020-2022年884201例预防性细胞学检查和5002例相应的组织学检查结果。在I/II-a正常组中，49例CIN2+病变被记录。修订后，71%（35例）仍留在I/II-a组。该修订导致16%（8例）被重新分类为0组，12%（6例）出现轻微差异。结论：由于高危HPV持续存在，尽管细胞学结果正常，但通过阴道镜和活检诊断CIN2+病变。这些病变占总人口的一小部分。造成这种差异的主要原因是细胞材料难以评估。在大多数发现差异的病例中，但细胞材料很容易评估，不存在发育不良的细胞。这表明这里真正的问题在于前分析阶段。有可能在拭子收集期间无法到达发育不良区域。系统报告标本质量和单独分类hpv阳性/细胞学上不显著的MN III发现可以改善诊断管理。

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

Geburtshilfe Und Frauenheilkunde 医学-妇产科学

CiteScore

2.50

自引率

22.20%

发文量

828

审稿时长

6-12 weeks

期刊介绍： Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.