Brit J Cancer:HPV疫苗接种对宫颈筛查的影响

2020-05-05 网络 网络

接种疫苗的女性CIN2+细胞学检查的PPV降低,而女孩接种年龄越小PPV降低更明显。从细胞学检查转向HPV检测可能会改善筛查性能。

人乳头瘤病毒(HPV)疫苗接种预计会降低细胞学检查的阳性预测值(PPV)。

近日,肿瘤领域权威杂志British Journal of Cancer上发表了一篇研究文章,研究人员纳入了153250名1989年至1993年期间出生的女孩,这些女孩自从接种HPV疫苗(2006年10月)以来一直居住在瑞典,并在23岁时接受了宫颈筛查。研究人员评估了她们的首次细胞学检查结果,并通过瑞典国家宫颈筛查注册中心(NKCx)对组织病理学诊断进行了评估。通过与瑞典国家HPV疫苗接种登记系统进行链接,研究人员确定了2级或更严重的宫颈上皮内瘤变(CIN2+)的细胞学检查异常的PPV,以及并根据疫苗接种状况确定的含有95%置信区间(CIs)的差异。

在未接种疫苗的妇女中,CIN2+以上级别的细胞学检查结果PPV为69.9%(95%CI为67.9–71.9)、64.9%(95%CI为59.8–69.8)和57.4%(95%CI为50.9–63.7),在调整出生队列后,接种疫苗组中在17-22岁年龄段进行疫苗接种以及在17岁之前接种疫苗的人群中PPV分别降低了8%(95%CI为0-15%)和17%(95%CI为7-26%)。

由此可见,接种疫苗的女性CIN2+细胞学检查的PPV降低,而女孩接种年龄越小PPV降低更明显。从细胞学检查转向HPV检测可能会改善筛查性能。

原始出处:

Jiayao Lei,et al.Impact of HPV vaccination on cervical screening performance: a population-based cohort study.British Journal of Cancer.2020.https://www.nature.com/articles/s41416-020-0850-6

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