细胞DNA倍体分析对宫颈高度鳞状上皮内病变诊断及随访价值研究

目的探讨细胞DNA倍体分析对宫颈高度鳞状上皮内病变HSIL+的诊断价值及HSIL-的随访意义。方法收集2013年1月至2014年12月在中山市博爱医院常规行宫颈癌筛查的妇女共1576例,均行液基细胞学检查(TCT)+细胞DNA倍体分析。任一结果阳性均行阴道镜活检,定义病理结果≥HSIL为病理阳性,HSIL为病理阴性。结合TCT及活检病理结果,分析细胞DNA倍体分析诊断HSIL+的价值及细胞DNA倍体分析对HSIL-的随访价值。结果 (1)1576例受检妇女细胞DNA倍体分析阳性率15.6%,TCT阳性率9.33%。阴道镜转诊率21.45%。(2)不同病理分级DNA异倍体细胞数(N)差异有统计学意义(χ2=259.5,P=0.000)。细胞DNA异倍体数(N)与宫颈病变严重程度呈正相关(r=5.322,P=0.000)。各年龄分组中细胞DNA倍体分析阳性率差异有统计学意义(χ~2=173.224,P0.01)。(3)细胞DNA倍体分析敏感度81.03%,TCT敏感度32.76%,差异有统计学意义(χ2=27.559,P0.01);细胞DNA倍体分析联合TCT检测敏感度可达87.93%。(4)对病理阴性患者随访2年可知,细胞DNA倍体阳性患者较阴性患者罹患HSIL+的风险高(P0.05)。结论细胞DNA倍体分析在宫颈癌筛查中对HSIL+的诊断及HSIL-的随访均有较高的临床价值,细胞DNA倍体分析联合TCT用于宫颈癌初筛优于单独的筛查方法。     

TCT联合HPV检测与多基因甲基化检测在宫颈病变诊断中应用价值分析

目的 分析液基薄层细胞学检测(TCT)联合人乳头瘤病毒(HPV)检测与多基因甲基化检测在宫颈病变诊断中的应用价值.方法 将2018年6月至2020年5月于成都医学院第二附属医院核工业四一六医院妇科就诊的298例宫颈病变高风险患者作为研究对象,均进行TCT联合HPV检测、多基因甲基化检测和阴道镜下宫颈病理活检,以病理结果为金标准,进行统计学分析,比较TCT联合HPV检测、多基因甲基化检测在宫颈病变中的诊断价值.结果 298例宫颈病变高风险患者中宫颈上皮正常90例,炎症84例,低级别鳞状上皮内病变(LSIL)47例,高级别鳞状上皮内病变(HSIL)50例,宫颈癌27例;TCT联合HPV检测对HSIL及宫颈癌诊断的灵敏度、特异性、阳性预测值和阴性预测值分别为90.91％、90.95％、77.78％和96.63％;多基因甲基化检测对HSIL及宫颈癌诊断的灵敏度、特异性、阳性预测值和阴性预测值分别为98.70％、97.29％、92.68％和99.54％;多基因甲基化检测对HSIL和宫颈癌的诊断结果与病理结果一致性分析显示Kappa值= 0.940,一致性极高.结论 相较于TCT联合HPV检测,多基因甲基化检测对HSIL及宫颈癌的诊断效能更高.     

浙江沿海地区宫颈病变患者中高危型HPV检测及其临床价值

目的 分析宫颈病变患者中高危型HPV的感染情况及特点,探讨HR-HPV DNA检测用于高级别宫颈上皮内瘤变中的价值.方法 回顾性分析采用液基薄层细胞学(TCT)检查、HR-HPV检测和阴道镜检查并行活检的官颈病变患者1130例临床资料.经病理组织学检查证实宫颈炎症448例,官颈上皮内瘤变Ⅰ级和(或)湿疣(CIN Ⅰ/HPV Ⅰ)212例,高级别官颈上皮内瘤变或官颈上皮内瘤变Ⅱ/Ⅲ级(C1NⅡ/Ⅲ)442例,宫颈浸润癌(均为鳞癌)28例.结果 1130例官颈病变患者中HR-HPV阳性率为65.84％(744/1130).细胞学异常者为862例,其中ASCUS356例、ASCH 84例、LSIL 216例、HSIL 184例、癌22例.病理学≥CINI/HPVI者682例,HR-HPV阳性率为78.59％(536/682).筛查≥CINⅡ病变TCT的灵敏度为88.94％,特异度为32.73％,阳性预测值为48.49％,阴性预测值为80.60％;HC-Ⅱ的灵敏度为90.21％,特异度为51.82％,阳性预测值为57.14％,阴性预测值为88.14％;两者联合的灵敏度为97.45％,特异度为22.42％,阳性预测值为47.22％,阴性预测值为92.50％.结论 HR-HPV在各年龄组宫颈病变患者中均有较高的感染率,随着宫颈病变程度的加深,HR-HPV的感染率逐步升高.HC-Ⅱ检测HR-HPV DNA是筛查宫颈上皮内瘤变可选用的方法.HR-HPV DNA检测是一种有效的ASCUS和LSIL的管理手段,有较高的灵敏度和阴性预测值.     

高危型人乳头状瘤病毒检测在不除外高度鳞状上皮内病变的不典型鳞状上皮细胞中的意义

目的 探讨高危型人乳头状瘤病毒(HR-HPV)的检测在宫颈细胞学不除外高度鳞状上皮内病变的不典型鳞状上皮细胞(ASC-H)中的意义.方法 对45例诊断为ASC-H的患者用杂交捕获二代(HC-Ⅱ)方法检测HR-HPV DNA含量,并进行阴道镜检查及活检,分析其结果之间的关系.结果 45例ASC-H的活检结果为宫颈鳞状上皮内病变(SIL)33例(73.3%);45例ASC-H中36例HR-HPV阳性,其中高度鳞状上皮内病变(HSIL)及以上病变者19例(52.8%);9例HR-HPV阴性病例中,没有HSIL及以上病变;HR-HPV对ASC-H患者HSIL的敏感性及阴性预测值均为100%.结论 ASC-H高度提示宫颈病变的存在;HR-HPV可以作为ASC-H患者是否需要立即阴道镜检查的一个预测指标,HR-HPV阳性者应立即阴道镜检查及活检,HR-HPV阴性是HSIL阴性的一个预测指标.     

高危型人乳头状瘤病毒和宫颈细胞学联合检测在诊断宫颈病变中的临床价值

目的 探讨高危型人乳头状瘤病毒(hish-risk human papillomavirus,HR-HPV)和宫颈细胞学联合检测在诊断宫颈病变中的临床价值.方法 对2004年10月至2006年12月北京大学第一医院就诊的患者进行HR-HPV检测和宫颈细胞学检查,对一项或两项结果异常者均行阴道镜下宫颈活检,并以宫颈活检结果为金标准,比较HR-HPV检测、宫颈细胞学检查、HR-HPV和宫颈细胞学联合检测对宫颈病变的诊断价值.结果 HR-HPV检测、宫颈细胞学检查及HR-HPV检测联合宫颈细胞学检查对诊断宫颈病变有不同价值.HR-HPV检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为94.83%、31.06%、55.22%、87.02%,宫颈细胞学筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为92.10%、31.06%、54.50%、81.43%,HR-HPV和宫颈细胞学联合检测筛查CINⅡ、CINⅢ的敏感度、特异度、阳性预测值和阴性预测值分别为99.65%、18.55%、61.46%、97.62%.结论 采用HR-HPV和宫颈细胞学联合检测可提高宫颈病变的检出率,并可指导临床医生对宫颈病变的治疗.     

HPV E6/E7 mRNA联合P16/ki67免疫细胞化学双染色检测在不典型鳞状细胞(ASCUS)分流诊断中的作用

目的探讨人乳头瘤病毒(HPV) E6/E7 mRNA联合P16/KI-67抗原(ki67)免疫细胞化学双染色检测对意义不明确的不典型鳞状细胞(ASCUS)分流诊断的价值。方法选取272例患者,回顾性分析剩余的细胞学标本中HPV E6/E7 mRNA及P16/ki67免疫细胞化学双染色检测结果。HPV E6/E7 mRNA检测采用HPV E6/E7 mRNA检测试剂盒利用Panther分子诊断仪进行检测、P16/ki67采用免疫细胞化学染色利用Ventana Benchmark Ultra免疫组织化学染色仪进行。分析两种检测法在同级别宫颈上皮病变中阳性率的差异,探讨两种检测法及二者联合检测在诊断高级别鳞状上皮内病变(HSIL)的效能的差异,综合评估不同检测方法分流诊断ASCUS中的作用。结果宫颈细胞学ASCUS对应的组织病理学结果包括慢性宫颈炎、低级别鳞状上皮内病变(LSIL)、HSIL到宫颈癌等。单纯分子诊断或免疫细胞化学染色检测阳性率随宫颈病变严重程度的加重而增加。在宫颈炎和LSIL病变组中,两种检测法阳性率之间的差异明显,在HSIL和宫颈癌病变组中,两种检测法阳性率之间无显著差异。联合检测法诊断HSIL以上病变的综合性能最佳,其灵敏度、特异度、约登指数、符合率、阳性预测值、阴性预测值分别为95. 65%、85. 40%、0. 81、87. 13%、57. 14%、98. 97%。结论 HPV E6/E7 mRNA和P16/ki67免疫细胞化学染色检测均在ASCUS分流诊断中有一定的意义,联合检测HPV E6/E7 mRNA和P16/ki67明显提高分流诊断的灵敏度,保持了较好的特异度。     

TCT检测联合DNA倍体分析在宫颈病变中的研究探讨

目的：探讨TCT检测联合DNA倍体分析对宫颈病变的诊断价值。方法收集2010年1月~2014年1月,我院妇产科收治的子宫良性病变患者158例,均在术前接受宫颈液基薄层细胞学检测(TCT)以及DNA倍体分析,并以术后病理诊断作为标准,统计两种方法的诊断阳性率。结果本组158例患者经TCT检查显示,阳性率为62.0%,其中,49例确诊为CIN及宫颈癌,准确率为50.0%;经DNA倍体分析显示,50例存在异常倍体,阳性检出率为31.6%,其中38例为CIN及宫颈癌,准确率为76.0%。结论TCT联合DNA倍体分析对宫颈病变早期筛查与诊断具有重要意义,值得推广应用。     

DNA倍体分析联合HPV-DNA23分型检测对ASC-US的诊断价值

目的探讨DNA倍体分析联合HPV-DNA 23分型检测(HPV检测)对子宫颈液基细胞学涂片(liquid-based preparation, LBP)报告的"不能明确意义的非典型鳞状细胞(atypical squamous cells of undetermined significance, ASC-US)"的诊断价值。方法收集64例ASC-US子宫颈细胞样本,制成LBP薄片2张,1张用于巴氏染色进行LBP TBS分级诊断,1张用于Feulgen染色进行DNA倍体分析,同样方法进行HPV检测;检测结果经子宫颈组织活检验证。结果 64例ASC-US经活检验证,其中22例阴性,为正常或炎症;42例阳性,包括低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion, LSIL)21例、高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion, HSIL)+癌(鳞状细胞癌1例)21例,阳性率为65.63%。在42例病理结果阳性中:DNA倍体分析和HPV检测共阳性22例,占比34.38%(22/64);DNA倍体分析或HPV检测阳性20例,占比31.25%(20/64);在21例HSIL+癌中,DNA倍体分析或HPV检测阳性6例,占比9.38%(6/64)。在22例病理结果阴性中:DNA倍体分析+HPV检测共阳性4例,占比6.25%(4/64);DNA倍体分析或HPV检测阳性15例,占比23.44%(15/64);DNA倍体分析+HPV检测共阴性3例,占比4.69%(3/64)。结论在LBP诊断ASC-US病例中,其DNA倍体分析和(或)HPV检测阳性时建议转诊阴道镜;而DNA倍体分析和HPV检测共阴性时建议采用常规LBP复查。DNA倍体分析联合HPV检测对子宫颈LBP筛查报告中的ASC-US病例具有辅助诊断价值。     

宫颈细胞学鳞状上皮内病变的诊断及风险管理

目的：探讨宫颈细胞学鳞状上皮内病变(squamous intraepithelial lesion,SIL)与组织学的关系,揭示细胞学SIL诊断的系统性风险及管理策略。方法：回顾性分析我院2013~2015年405例SIL,其中205例有组织学检查,比较两种结果的符合程度,对其差异产生的原因进行分析。结果：低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)的阳性预测值约71%,而HSIL的阳性预测值达98%以上。结论：细胞学高度鳞状上皮内病变(high-grade squamous intraepithelial lesion, HSIL)与组织学结果一致性良好,而LSIL与组织学结果符合度较差,需要加强对LSIL的管理。     

子宫颈低级别鳞状上皮内病变与HR-HPV的关系

目的探讨高危型人乳头状瘤病毒(high risk human papillomavirus,HR-HPV)在子宫颈低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)中的分布特点及感染方式,并分析其在LSIL中的作用。方法应用实时荧光定量PCR和HPV原位杂交技术对328例诊断结果为168例LSIL、160例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)的子宫颈组织蜡块进行HPV分型检测。结果 HE染色结果显示,LSIL的病变细胞集中在子宫颈鳞状上皮表层,HSIL的病变细胞主要集中在上皮下层。168例LSIL患者中HR-HPV阳性率95.2%;LSIL、HSIL中HPV 16、18阳性率分别为26.2%、57.5%,其他型HR-HPV(不包括HPV 16、18)的阳性率分别为80.9%、55.0%,差异均有统计学意义(P0.001)。在原位杂交检测组中,HR-HPV的阳性率为70.2%,HR-HPV阳性LSIL中,棕黄色阳性细胞位于子宫颈鳞状上皮表层、中层,基底层未见阳性细胞。结论 HR-HPV感染与LSIL的发生、发展密切相关,尤其是其他型HR-HPV(不包括HPV 16、18);LSIL患者中HR-HPV的感染开始于子宫颈鳞状上皮表层。     

潮州地区高危型人乳头瘤病毒载量与宫颈病变的关系

目的探讨高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)载量与宫颈病变级别之间的关系。方法采用RT-PCR对农村35～60岁女性进行HR-HPV DNA定量检测并记录CT值,2 731例阳性者再进行核酸分子快速导流杂交分型技术(HybriMax)和液基薄层细胞学(thinprep liquid-based cytologic test,LCT)检查;对低级别鳞状上皮内病变(low grade squa-mous intraepithelial lesion,LSIL)及以上病变行阴道镜下组织病理学活检。根据LCT及病理活检结果按病变级别分成5组:无上皮内瘤变或恶性病变(non-squamous intraepithelial lesion or neoplasia,NILM)、未明确诊断意义的不典型鳞状上皮细胞(atypi-cal squamous cells of undetermined significance,ASCUS)、LSIL、高级别鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)和鳞状细胞癌(squamous cell cacinoma,SCC)。在同级别宫颈病变中,按照HPV感染的类型分为4组:HPV52、HPV16、HPV58和多重HPV感染。采用方差分析的方法对各组平均CT值进行统计分析。结果随宫颈病变级别的升高,CT均值降低,5组CT均值间差异均具有显著性(P<0.05)。在同级别宫颈病变中,NILM组HPV58和多重HPV差异有显著性(P<0.05),ASCUS组HPV16和多重HPV差异有显著性,其余病变级别各HPV感染组间差异均无显著性(P>0.05)。结论 HR-HPV载量与宫颈病变级别呈正相关,高HR-HPV载量是影响宫颈病变级别的危险因素。     

Usefulness of DNA ploidy measurement on liquid-based smears showing conflicting results between cytology and high-risk human papillomavirus typing

To improve the positive predictive value (PPV) for high-risk human papillomavirus (HR-HPV) in primary screening, DNA ploidy was measured on the same liquid-based sample by image cytometry in 984 cases showing discrepancies between cytology and HR-HPV testing. Of the conflicting results, 14.5% corresponded to a cytologic lesion (from atypical squamous cells of undetermined significance to high-grade squamous intraepithelial lesion [HSIL]) without HPV detected, and 85.5% of smears were within normal limits but revealed an HR-HPV infection. A suspect DNA profile was associated significantly with a lesion. In 497 patients who underwent repeated HPV testing, a normal DNA profile at the first smear predicted the clearance of HPV infection (sensitivity, 81.5%; specificity, 45.4%; PPV, 69%; negative predictive value, 62.4%). In persistent HR-HPV infection, a suspect DNA profile at the first smear increased the PPVfrom 10.8% to 22.7% for the detection of a histologically proven HSIL with a sensitivity of 95.2%. DNA ploidy can be used to select smears with high risk of HSIL, especially in cases of persistent HR-HPV infection.     

Evaluation of the detection of human papillomavirus genotypes in cervical specimens by hybrid capture as screening for precancerous lesions in HIV-positive women

Given the frequency and persistence of human papillomavirus (HPV) infection and associated cytological alterations in HIV-1-positive women, the incidence of uterine cervix neoplasm is likely to increase along with patient survival. More appropriate screening programs, which, in addition to Pap smears (PS), also include tests to detect and type HPV, are needed for the early identification of precancerous cervical lesions. This prospective study involved 168 HIV-positive (group A) and 100 HIV-negative women (group B). Cervicovaginal samples were collected for a PS and HPV DNA search. The detected virus was typed as high–intermediate oncogenic risk HPV (HR-HPV) and low-risk HPV (LR-HPV) using hybrid capture (HC) (Murex-Digene) and in-house PCR tests. The HC-detected prevalence of HPV was 111/168 (66%:HR 75.6%) in group A and 15/100 (15%:HR 42.9%) in group B (P < 0.0001). Polymerase chain reaction (PCR) was positive in 91% and 48%, respectively. No significant difference was observed between drug addicts and heterosexual HIV-1-positive women (P = 0.09). HPV was detected in 94% of the 57 HIV-positive women with cytological alterations. HR-HPV was found in 41/49 women with low-grade and 7/8 with high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively). In women with a negative PS, HPV was detected in 57/111 cases (HR 63%) of group A and in 13/98 of group B (6 cases of HR). Of the 54 group A women who underwent biopsy, histology revealed that 41 had LSIL (18 with negative PS, 19 with LSIL, and 4 with HSIL; HR-HPV in 73% and LR-HPV in 17%), nine had HSIL (5 LSIL and 4 HSIL on cytology; HR-HPV in 89% and LR-HPV in 11%), and four were negative (all cytology negative; 3 HR-HPV and 1 LR-HPV). HR-HPV was more frequent as immunodepression worsened. These results show that cytological evaluation alone underestimated histological alterations in 23/50 women (42.6%), whereas the combination of Pap smear and HPV detection reduced this underestimate to 5%. J. Med. Virol. 56:133–137, 1998. © 1998 Wiley-Liss, Inc.     

Cell cycle and/or proliferation markers: what is the best method to discriminate cervical high-grade lesions?

The aim of this study on a series of biopsies diagnosed as normal, metaplastic, low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs) was dual: to determine the chronology of cell cycle and proliferation abnormalities after human papillomavirus infection during the development of squamous intraepithelial lesions and to determine the best diagnostic indicator(s) linked to the appearance of an HSIL. Ninety-nine cervical biopsies, 18 normal, 9 with metaplastic changes, 29 LSIL, and 43 HSIL (23 cervical intraepithelial neoplasia 2 and 20 cervical intraepithelial neoplasia 3), were analyzed by image cytometry for DNA ploidy and p16INK4A determination, AgNOR counting, MIB-1, and ICBP90 immunostaining quantification. The human papillomavirus status had been previously determined on corresponding cytological smears with the Hybrid Capture II test. Suspect DNA profile and p16INK4A staining were the first significant events that preceded the increase of cell proliferation. Indeed, these markers were the best tests for the detection of a lesion, whatever its grade (positive predictive values of 90% and 100%, respectively). The presence of MIB-1- or ICBP90-positive cells in the upper two thirds of the epithelium was a very accurate feature to select HSIL (sensitivity, 100% for MIB-1) but with a low specificity. The sensitivity of a suspect DNA profile associated with a positive MIB-1 or ICPB90 immunostaining for the detection of an HSIL was, respectively, 92.8% and 92.7%; their specificities were 54.2% and 44%; their positive predictive values were 78% and 73%; their negative predictive values were 81.2% and 78.6%; and the global values were 78.8% and 74.3%. Thus, the most accurate test to distinguish an LSIL from an HSIL was the association of a suspect DNA profile and the presence of MIB-1- or ICBP90-positive cells in the upper two thirds of the epithelium.     

Efficiency of immunohistochemical p16 expression and HPV typing in cervical squamous intraepithelial lesion grading and review of the p16 literature

Diagnosing and grading cervical cancer precursors is challenging. This study investigates the presence of HPV infection, the expression of p16, and any correlation between these two findings. H&E-stained slides of cervical loop excision materials diagnosed as LSIL and HSIL were reviewed. An immunohistochemical panel consisting of p16 as well as of all HPV types and HR-HPV types was applied. Staining of p16 was evaluated according to distribution extent and degree of intensity. All HSIL cases and 80% of LSIL cases were positive for p16. In HSIL cases, the staining distribution was as follows: 50% full thickness, 45% basal, and 5% rare. The staining intensity for the same cases was strong in 70%, variable in 20%, and weak in 10% accordingly. In LSIL cases, staining distribution was basal in 58.3% and rare in 41.7%. None of the LSIL cases showed full thickness of p16 positivity. The staining intensity of the same cases was strong in 25%, variable in 16.7%, and weak in 58.3%. Of all cases, 48.6% were positive for screening kit (all HPV types), and 31.4% of all cases were positive for HR-HPV. The distribution of this positivity was 35% for HSIL and 26.6% for LSIL cases. The total HPV-type positivity rate was 48.6%, the distribution being 50% for HSIL and 46.6% for LSIL cases. p16 is a highly sensitive marker for cervical epithelial dysplasia. Strong and full thickness staining of p16 in the cervix epithelium is highly supportive of HSIL, while weak and basal/rare staining favors LSIL. All HPV-positive cases were also p16-positive, but no statistically significant relationship between HPV infection positivity and the intensity and distribution of p16 was found. HPV is not helpful in the grading of SIL, as an unignorable rate of HR-HPV positivity (26.6%) was detected in LSIL group.     

Detection of HPV16 and 18 by in situ hybridization in precancerous and cancerous lesions of cervix

Fifty cervical biopsies from women with preinvasive and invasive malignancies of uterine cervix and ten normal cervical biopsies were examined for the presence of human papilloma virus (HPV) 16 and 18 DNA sequences by in situ hybridization (ISH) method with biotinylated DNA probes. The overall positivity of HPV DNA was 48% (24/50). The positivity of HPV 16 DNA for low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC) were 33.33%, 45.45%, 42.30% respectively. The positivity for HPV 18 DNA for LSIL, HSIL and SCC were 0%, 18.18%, 30.76% respectively. Two cases of cervical adenocarcinomas showed positivity for HPV 18 DNA only.     

Qualification of ASCUS. A comparison of equivocal LSIL and equivocal HSIL cervical cytology in the ASCUS LSIL Triage Study

Cytologic detection of high-grade squamous intraepithelial lesions (HSILs) is critical to cervical cancer prevention. Therefore, identifying "equivocal HSIL" (ASCUS [atypical squamous cells of undetermined significance]-H) may be useful. Accordingly, we compared findings associated with "equivocal low-grade SIL" (ASCUS-L), ASCUS-H, and HSIL using data from the ASCUS LSIL (low-grade squamous intraepithelial lesion) Triage Study. The frequency of oncogenic human papillomavirus (HPV) DNA detection and underlying lesions cervical intraepithelial neoplasia (CIN) 2 or worse or CIN 3 or worse in women with ASCUS-H was intermediate between that of ASCUS-L and HSIL. Oncogenic HPV DNA was associated with 85.6% of ASCUS-H ThinPreps and 69.8% of ASCUS-H smears. Histopathologic lesions CIN 2 or worse were associated with 40.5% of ASCUS-H ThinPreps and 27.2% of ASCUS-H smears (mostly CIN 3). Nevertheless, numerically more lesions CIN 2 or worse were preceded by ASCUS-L than by ASCUS-H because ASCUS-L was more common. ASCUS-H is an uncommon interpretation that derives clinical usefulness from its high positive predictive value for lesions CIN 2 or worse.     

Co-expression of metalloproteinases 11 and 12 in cervical scrapes cells from cervical precursor lesions

The metalloproteinases (MMP) 11 and 12 have been shown to be expressed in cervical cancer (CC). In order to extend our previous results, these MMPs were evaluated in cervical precursor lesions. One hundred seventeen cervical scrapes: thirty-six normal, thirty-six low grade squamous lesions (LSIL), thirty-six high grade (HSIL), nine CC; and, also ninety-nine paraffin-embedded cervical lesions: fifteen normal cervices, thirty eight LSIL, sixteen HSIL, and five CC were collected. The samples were analyzed for relative expression by real time RT-PCR or immunohistochemistry assay. We were able to identify a relative increased expression of MMP11 in 75% and 78% from LSIL and HSIL samples, respectively. While MMP12 expression was 64% and 75% in LSIL and HSIL, respectively. Positive samples for MMP11 expression were also positive for MMP12 expression and also increased according to illness progression. In the tissues, MMP11 or MMP12 expression was observed in the cytoplasm of the neoplastic cells, while in the normal epithelium was absent. The reaction was always stronger for MMP12 than MMP11. MMP11 expression was present in 77% and 66% of LSIL and HSIL, while MMP12 expression was 73% and 68%. There was a relationship between MMP11 or MMP12 expression and HPV infection. Our data are showing a relationship between diagnostic of precursor lesions and the MMP11 and 12 expressions, suggesting that their expression could be an early event in the neoplastic lesions of the cervix and could have clinical significance.