子宮頸がん検診における HPV 検査の導入とその有用性

@article{2008H,
  title={子宮頸がん検診における HPV 検査の導入とその有用性},
  author={正紘 丹後 and 太郎 金谷 and 茂男 橋本 and 信政 前川 and 俊彦 浮田 and 信二 小山 and 誠 丘村 and 正樹 井上},
  journal={The Journal of the Japanese Society of Clinical Cytology},
  year={2008},
  volume={47},
  pages={1-6}
}
目的: 子宮頸がん検診に従来の細胞診に HPV 検査を導入することの有用性を検討した.方法: ベセスダシステム (2001) で意義不明の異型扁平上皮細胞を ASC と分類している. 平成 16∼18 年の 3 年間の金沢市民を対象にした行政の子宮頸がん検診において, ASC (ASC-US と ASC-H) 例にハイブリッドキャプチャー 2 (HC2) で高リスク型 HPV の検査を併用し, HPV 陽性例と軽度異形性以上の病変を推定した例にコルポスコープ下の組織検査を行い, HPV 検査導入前の 3 年間と比較検討した.成績: 3 年間の金沢市の子宮頸がん検診受診者 3 万 3790 人中 ASC は 1565 人 (4.6%) で, そのうち 221 例 (14.1%) が HPV 陽性であった. 221 例中精検受診者は 169 例 (76.5%) で, そのなかから CIN2 以上が 27 例検出された. 浸潤がんは認めなかった.結論: 細胞診で判定の難しい ASC 例に対し, HPV… 
2 Citations
Present status of cervical cancer screening based on The Bethesda System (TBS) in Osaka Prefecture with special reference to guideline management of ASC-US and detection of high-risk HPV-DNA
TLDR
The results show that high-risk HPV patients are more likely to be exposed to infectious disease than the general population as a whole.

References

SHOWING 1-10 OF 18 REFERENCES
The evaluation of human papillomavirus DNA testing in primary screening for cervical lesions in a large Japanese population
TLDR
HPV DNA testing in combination with cytology significantly improved the efficacy to CIN screening, and in terms of both sensitivity and positive predictive value in detecting the CIN, HPV DNA testing is superior to cytology.
High-Risk HPV DNA Detection Rate in Patients with Atypical Squamous Cells and Its Relationship to the Atypical Squamous Cell:Squamous Intraepithelial Lesion Ratio
TLDR
The authors' ASC:SIL ratios (except for 1 pathologist) and high-risk HPV DNA detection rates were within an acceptable range and did not observe any association between the atypical squamous cell (ASC):squamous intraepithelial lesion (SIL) ratio and high -risk HPV detection rate.
Baseline cytology, human papillomavirus testing, and risk for cervical neoplasia: a 10-year cohort analysis.
TLDR
Positive combined test results should provide added reassurance for lengthening the screening interval among low-risk women, whereas positive results identify a relatively small subgroup that requires more frequent surveillance.
Human papillomavirus testing in primary screening for the detection of high-grade cervical lesions: a study of 7932 women
TLDR
HR-HPV testing could be proposed in primary screening in association with cytology and with conventional cytology it significantly improves the detection of HGSIL.
Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8466 patients
TLDR
Data show that HPV testing is of value for the detection or exclusion of prevalent CIN in a routine cervical cancer-screening setting and could be used for further risk classification of women for follow-up management.
Atypical Squamous Cells of Undetermined Significance: Human Papillomavirus Testing in Adolescents
TLDR
Given that the rate of oncogenic HPV infection approached 80% in the population of adolescent women with ASC-US, the usefulness of HPV testing in this age group requires further investigation.
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