Aiming to improve the precision of cervical cancer screening

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  • 子宮頸がん検診の精度向上を目指して

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 Objective: The cause of cervical cancer has been clarified as human papillomavirus (HPV). Moreover, in order to detect precancerous change, it is very important to increase the cervical cancer screening attendance rate and to improve the precision of cervical cancer screening. In recent years, Liquid Based Cytology (LBC) has been introduced in the field of gynecology. This study therefore reports our comparison and consideration of the results obtained in high-risk HPV testing conducted using LBC and conventional cytology.<br> Subjects: We examined 18,956 cases for whom cervical cytology was performed in our clinic from January to December 2011.<br> Methods: Conventional cytology by scraping with brushes was conducted for 18,956 cases, and LBC (TACAS system) and high-risk HPV tests were conducted on split sample preparations for 1,227 consenting cases. High-risk HPV (Hybrid Capture 2 Method) test requests were sent to BML.<br> Results: The inadequacy rate with conventional cytology was 0.2<clig:0><cotfcalt:0>%<clig:><cotfcalt:>(44/18,956) and the inadequacy rate with LBC was 0 <clig:0><cotfcalt:0>%<clig:><cotfcalt:>(0/1,227). The determination of LBC preparations shows a concordance of 95.2 <clig:0><cotfcalt:0>%<clig:><cotfcalt:>(1,168/1,227) with the conventional cytology determination. In terms of the detection rate of ASC-US or worse results, the detection rate with LBC was higher than that with conventional cytology. The HPV positive rate was 6.9 <clig:0><cotfcalt:0>%%<clig:><cotfcalt:>(85/1,227). Of 1,137 cases who tested negative for NILM with both conventional cytology and LBC, 2.4<clig:0><cotfcalt:0>% <clig:><cotfcalt:>(27/1,137) were HPV positive; moreover, follow-up results indicated that CIN1 or LSIL was recognized in 48 <clig:0><cotfcalt:0>%<clig:><cotfcalt:>(13/27) of these cases. Compared with conventional cytology, with LBC, cells smeared more evenly and atypical cells were detected more easily because of the relative paucity of blood effects.<br> Conclusions: The study results suggest that adopting LBC has the potential to reduce the number of unacceptable specimens and improve detection sensitivity for atypical cells. A combination of HPV testing and LBC is expected to improve management of ASC-US and the sensitivity of screenings.

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