JNCI:宫颈癌风险评估,HPV DNA优于宫颈抹片

2014-07-22 何Jason 新浪微博@医学专业新闻

据在线发表于Journal of the National Cancer Institute(JNCI)的一项研究显示,HPV DNA在评估宫颈癌风险的准确性方面更为优胜。研究主要作者为美国国家癌症研究所(National Cancer Institute,NCI)下属癌症流行病学和遗传学分部的Julia Gage博士后。在这项研究中,作者共分析了超过一百万名妇女的数据。这些妇女均为美国加州人,年

据在线发表于Journal of the National Cancer Institute(JNCI)的一项研究显示,HPV DNA在评估宫颈癌风险的准确性方面更为优胜。研究主要作者为美国国家癌症研究所(National Cancer Institute,NCI)下属癌症流行病学和遗传学分部的Julia Gage博士后。

在这项研究中,作者共分析了超过一百万名妇女的数据。这些妇女均为美国加州人,年龄处于30岁至64岁,于2003年至2012年间接受了HPV DNA和宫颈抹片检查。

他们发现,如果HPV DNA检查结果为阴性,则三年内发生宫颈癌的风险极低(11/100,000 ),其风险预测的准确性优于宫颈抹片(20/100,000)。

作者认为,HPV DNA完全可以取代宫颈抹片,成为宫颈癌筛查的主要工具。

来自纽约北岸医疗集团的Dr. Jill Maura Rabin认为,HPV DNA检测在风险评估方面更具优势。每年一次的宫颈癌筛查不但有助排除癌变可能,还有助医患之间的沟通,解决患者在健康方面的疑问。但她指出,阴性的筛查结果并不代表不会患上宫颈癌。患者可能由于更换性伴侣或疾病相关免疫系统受损等,导致HPV感染风险增加,同样可引起宫颈癌风险的增加。

目前,美国预防服务工作组对宫颈癌筛查的建议是:21岁至65岁的女性每3年接受一次宫颈抹片筛查,或每5年接受一次HPV DNA+宫颈抹片筛查。

原始出处:


Gage JC1, Schiffman M2, Katki HA2, Castle PE2, Fetterman B2, Wentzensen N2, Poitras NE2, Lorey T2, Cheung LC2, Kinney WK2.Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test.J Natl Cancer Inst. 2014 Jul 18;106(8). pii: dju153. doi: 10.1093/jnci/dju153. Print 2014 Aug.

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    2014-07-24 一闲

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宫颈癌是最常见的妇科恶性肿瘤。大多数宫颈癌发生在那些没有接受过筛查或筛查不足的女性中。有调查发现,50%的宫颈癌患者从未接受过宫颈细胞学检查,另有10%的患者在确诊宫颈癌前5年内都没有接受过筛查。因此,大约60%的宫颈癌患者存在筛查不足的问题。 高危型HPV持续感染是宫颈癌的主要危险因素。近年来,宫颈细胞学筛查的普遍应用使癌前病变和宫颈癌得以早期发现和治疗。目前,宫颈癌的发病率和死亡率已有明显下

The Lancet:宫颈癌HPV筛查优于细胞学检查

尽管敏感性不高,但传统的宫颈癌细胞学检查方法(宫颈癌刮片检查)一直以来都是最成功的癌症筛查方案。在大规模、高质量开展该项检查手段的国家和地区,侵袭性宫颈癌发生率和死亡率呈直线下降趋势。在此前提下,为什么要改变这一检查手段呢? 自从鉴别出人乳头瘤病毒(HPV)是侵袭性宫颈癌的原因,人们开发了HPV DNA检查手段以应对这一疾病。分子学技术在检出2级或3级宫颈上皮内瘤(CIN2或CIN3)病