The impact of HPV vaccination on colposcopy the detection of high-grade squamous intraepithelial lesion
Objective To examine the impact of human papillomavirus(HPV)vaccination status on the histological detection of high-grade squamous intraepithelial lesion and above(HSIL+)guided by colposcopy.Methods This is a retrospective study including 2 289 patients who underwent endocervical curettage(ECC)from June 2020 to December 2022 in the Department of Obstetrics and Gynecology of Peking University First Hospital.Patients are divided into two groups based on their vaccination status:those who have received the HPV vaccine(629 cases)and those who have not received the HPV vaccine(1 660 cases).Using histopathology as the diagnostic gold standard and colposcopy impression of HSIL+as the threshold,clinical data of patients were analyzed to evaluate the effects of HPV vaccination on the sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of HSIL+on histology.Results ① The proportion of high-grade abnormalities on cytology in the vaccinated group(4.9％,31/629)was significantly lower than in the unvaccinated group(8.4％,139/1 660)(x2=7.874,P=0.005).the prevalence of HPV 16/18 positive was also lower in the vaccinated group(28.5％,179/629),compared with the unvaccinated group(39.0％,647/1 660)(P＜0.001).② A total of 536(23.4％)HSIL+cases confirmed by histology.The difference between the rates of HSIL+among those who are vaccinated(17.0％,107/629)and those who are not vaccinated(25.8％,429/1 660)was statistically significant(P＜0.001).③ The PPVs of colposcopy for HSIL+were 55.0％in the vaccinated group and 66.0％in the unvaccinated group,showing no statistical difference(P＞0.05).However,among the HPV16/18 positive patients in the vaccinated group,the PPV of colposcopy for HSIL+is significantly lower than that in the unvaccinated group.Conclusions HPV vaccination has no significant effect on the histological detection of HSIL+on colposcopy-guided biopsy.As colposcopy is still a useful tool for the management of abnormal cervical cancer screening results,no change to the current management process needs to be made based on HPV vaccination status.
cervical cancer screeninghuman papillomavirus vaccinecolposcopyhigh-grade squamous intraepithelial lesions of cervix
万方数据
维普
