자궁경부 병변의 진단에 질 확대경 및 인유두종 바이러스 검사법의 유용성 = Utility of Colposcopy and Human Papillomavirus (HPV) Test in the Diagnosis of Uterine Cervical Lesions

다국어 초록 (Multilingual Abstract)

Specific types of HPV are currently implicated as etiologic agents of precursors and cancerous lesions of the uterine cervix. This study used the data gained from one hundred twenty five women who underwent concurrent. Papanicolaou smear, colposcopic diagnosis, and cervicovaginal lavage for HPV BNA test at Dysplasia Clinic in Kangnam St. Mary's Hospital. 38 patients had low-grade squamous intraepithelial lesions (LGSILs) and 34 had high grade squamous intraepithelial lesions (HGGILs), 24 invasive cervical cancers, and 29 normal control. Colposcopic features were prosectively recorded by Reid's colposcopic index and then correlated with histopathologic diagnosis. Using the colposcopic index, 86.4% was correlated with histopathologic findings. DNAs extracted from the cervicovaginal lavages were analyzed by polymerase chain reaction (PCR) using the HPV L1 consensus primers. HPV DNA was detected in 79 of 125 women (63.2%). Prevalences of HPV DNA in the patients with LGSIL (71.1%), HGSIL, (76.5%i) and cervix caneer (75.0%) showed no difference in statistics. Low-risk oncogenic viruses.(HPV-6/11) were present in 13.2% of patients with LGSIL, but none was detected in those with HCSIL and cervix cancer. Intermediate-risk oncogenic viruses (HPV-31/33/35) were detected in 5.3% of patients with LGSIL 8.8% in HGSIL, and none in cervix cancer. Prevalence of high-risk oncogenic type HPV 16/18 was higher in HGSIL (41.2%) and invasive cervical cancer (45.8%) than those of LGSII (15.8%) and controls (3.5 % ) (P -= 0.0(01).
These data indicate that colposcopic scoring has adjunctive diagnostic role in predicting his-tology. And, HPV DNAs were found in similar incidence in the various histologic grades of cervical neoplasia. HPV-6/11 were detected only in LGSIL and HPV 31/33/35 in LGSIL and HGSIL, but not in invasive cancer. HPV-16/18 were the predominant viruses which were detected in HGSIL, and invasive cervical cancer.
In canclusizn, a combination of HPV testing and colposcopic scoring would provide sensitive screening methods for cervical cancer and precanceraus lesions. And HFV typing might have prognostic value in the management of patients with HPV related cervical neoplastic lesions.