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Nida Jareemit,Navin Horthongkham,Suwanit Therasakvichya,Boonlert Viriyapak,Perapong Inthasorn,Mongkol Benjapibal,Vuthinun Achariyapota,Irene Ruengkhachorn 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.4
영어 ObjectiveTo investigate the distribution of human papillomavirus (HPV) genotypes in low-grade squamous intraepithelial lesion(LSIL) cytology and the immediate risk of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) lesions. MethodsThis prospective cross-sectional study enrolled women aged ≥21 years that were diagnosed with LSIL cytology at SirirajHospital (Bangkok, Thailand) during 2017-2019. Anyplex II HPV testing was performed to detect 14 high-risk HPVcases prior to colposcopy-directed biopsy. ResultsIn total, 318 patients were included in the final analysis. Of those, 24 (7.5%), 241 (75.8%), 53 (16.7%) were aged 21-25 years, 25-50 years, and ≥50 years, respectively. Eighty-two patients (25.8%) had abnormal screening results withinthe previous 5 years. High-risk HPV infection was found in 188 patients (59.1%) with 127 (39.9%) having single and61 (19.2%) having multiple infections. The five most common HPV genotypes were HPV 66 (18.6%), HPV51 (9.7%),HPV58 (9.4%), HPV16 (9.1%), and HPV56 (8.2%). The immediate risk of CIN2+ was 6% in LSIL, regardless of the HPVstatus, 8% in high-risk HPV-positive LSIL, and 3.1% in high-risk HPV-negative LSIL. When using 6% as the thresholdrisk for colposcopy, performing reflex HPV testing in LSIL cytology can decrease the number of colposcopies by 40.9%,with an area under the receiver operating characteristic curve of 0.6 (95% confidence interval, 0.5-0.7). ConclusionThe study findings support the idea that geographic variations affect the HPV genotype. Reflex HPV testing maydecrease the number of colposcopies in cytology-based screening regions with a high prevalence of low-carcinogenicHPV.
Pichamon Sukkasame,Nida Jareemit,Awassada Punyashthira,Perapong Inthasorn,Nopwaree Chantawong,Komsun Suwannarurk,Piyawan Pariyawateekul,Siriwan Tangjitgamol,Thai Gynecologic Cancer Society Research Gr 대한산부인과학회 2024 Obstetrics & Gynecology Science Vol.67 No.3
Objective To compare attitudes toward self-sampling for human papillomavirus (HPV) testing before and after specimen collection in women undergoing colposcopy. The factors associated with the pre-sampling attitude were also studied. Methods This prospective study enrolled women with abnormal cervical cytology and/or positive high-risk HPV who attended colposcopy clinics at 10 cancer centers in Thailand between October 2021 and May 2022. Prior to colposcopy, the attitudes of the women toward self-sampling were surveyed through a questionnaire. Written and verbal instructions for self-sampling were provided before the process and subsequent colposcopy. The attitudes toward self-sampling were reassessed after the actual self-sampling. Factors associated with the attitudes were analyzed. Results A total of 499 women were included in this study. The mean age was 39.28±11.36 years. A total of 85.3% were premenopause, and 98.8% had sexual experience. With the full score of 45, the attitude score after self-sampling was significantly higher than the attitude score before self-sampling (39.69±5.16 vs. 37.76±5.71; P<0.001). On univariate analysis, the factors associated with attitude before HPV self-sampling were age, menopausal status, sexual activity, education level, income, knowledge regarding HPV, and prior high-grade squamous intraepithelial lesion histology. The remaining significant factor on multivariate analysis was sexual activity within the past year (B=0.105, 95% confidence interval, 0.014-2.870; P=0.048). Conclusion Attitudes toward self-sampling improved after the actual self-sampling process, as evidenced by higher attitude scores. Sexual activity was the only independent factor related to the attitude before self-sampling.