Predictive value of human papillomavirus type for histological diagnosis of women with cervical cytological abnormalities

摘要

In the past 10 years ablative treatment modalities for cervical intraepithelial neoplasia have been replaced by electrosurgical loop excision of the transformation zone in many centres. Gynaecologists who master the electrosurgical technique are inclined to treat without biopsy. Concern has been expressed that this leads to overtreatment, as cytological abnormalities may result from benign reactive changes. The broad spectrum of different human papillomavirus types has recently been grouped on the basis of a phylogenetic or evolutionary tree. The main branches of this tree lead to specific groups of human papillomavirus types with similar tissue tropism and oncogenic potential. One of the main branches comprises type 16 and related viruses such as types 31 and 33. Human papillomavirus type 18 belongs to a separate main branch. We investigated whether analysis of human papillomavirus in cervical scrapes might help in the better selection of patients for loop electrosection at the first visit.