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저등급 자궁경부세포이상의 처치에 있어서의 인유두종 바이러스 DNA의 검색의 의의

Other Titles
 The Value of Human Papillomavirus DNA Detection in management of Low Grade Cervical Cytologic Abnormalities 
Authors
 연정은  ;  김재욱  ;  김영태 
Citation
 Korean Journal of Obstetrics and Gynecology (대한산부인과학회잡지), Vol.42(10) : 2334-2340, 1999 
Journal Title
 Korean Journal of Obstetrics and Gynecology (대한산부인과학회잡지) 
ISSN
 0494-4755 
Issue Date
1999
Keywords
ASCUS ; LSIL ; HPV ; 중요성을 판단할 수 없는 비정형 편평세포 ; 저등급 편평상피내손상 ; 인유두종바이러스
Abstract
Objectives: Objective: The diagnosis of ASCUS(atypical squamous cells of undetermined significance) and LSIL(low-grade squamous intraepithelial lesion) was introduced in 1988 by the Bethesda system for reporting cervical/vaginal cytologies. A significant proportion of women referred for colposcopy with low grade cervical cytologic abnormalities(ASCUS and LSIL) will have high grade cervical intraepithelial neoplasia(CIN II or CIN III) and therefore require adequate management. The purposes of this study were to evaluate the usefulness of high risk type HPV(human papillomavirus) DNA detection using PCR(polyerase chain reaction) in patients with low grade cervical cytologic abnormalities in the prediction of high grade CIN and invasive cancer and to determine the clinical triage in the management of low grade cervical cytologic abnormalities. Methods: We reviewed 18,942 cases of Papanicolau smears that were performed at our hospital from Jan. 1995 to Mar. 1999. Colposcopically directed biopsy or LLETZ(large loop excision of transformation zone) or hysterectomy were performed on 318 patients with abnormal PAP smears of low degree. HPV PCR testing of high risk types(16 and 18) was also performed on 115 patients. Results: Histologic outcome of ASCUS included 43 cases(38.4%) of high grade CIN and invasive cancer, and that of LSIL included 65 cases(47.5%) of high grade CIN and invasive cancer. In cases of high risk HPV type, 19 patients(73.1%) were at age over 30 years. A highly significant correlation was found between a positive test for high risk types of HPV and finding of high grade CIN and invasive cancer. Among 51 women with ASCUS, a positive test for high risk type had a sensitivity and specificity of 40.0% and 86.1%, and positive predictive value(PPV) and negative predictive value(NPV) of 54.5% and 77.5%, respectively. In 64 women with LSIL, a positive high risk type test was associated with sensitivity and specificity of 30.0% and 94.1%, and PPV and NPV of 81.8% and 60.4%, respectively. Conclusion: Our results suggest that high risk type HPV may be positively predictive of and may act as a surrogate marker for high grade CIN and invasive cancer in women with low grade cervical cytologic abnormalities. The management of women with a low grade cervical cytologic abnormalities should be active such as colposcopically directed biopsies.
Full Text
http://kiss.kstudy.com/thesis/thesis-view.asp?key=1857542
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174324
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