Abstract:
OBJECTIVE:For the 2019 ASCCP Risk-Based Management Consensus Guidelines, we conducted a systematic review of diagnostic assays for postcolposcopy and posttreatment management. MATERIALS AND METHODS:A literature search was conducted to identify articles reporting on tests/assays for cervical cancer screening, triage, postcolposcopy surveillance, and posttreatment surveillance published between 2012 and 2019 in PubMed and Embase. Titles and abstracts were evaluated by co-authors for inclusion. Included articles underwent full-text review, data abstraction, and quality assessment. Pooled absolute pretest and posttest risk estimates were calculated for studies evaluating management of patients after treatment. RESULTS:A total of 2,862 articles were identified through the search. Of 50 articles on postcolposcopy, 5 were included for data abstraction. Of 66 articles on posttreatment, 23 were included for data abstraction and were summarized in the meta-analysis. The pooled posttreatment risk of cervical intraepithelial neoplasia (CIN) 2+ in all studies was 4.8% (95% CI = 3.4%-6.8%), ranging from 0.4%-19.5% (τ = 0.57) in individual studies. Among individuals testing negative for human papillomavirus (HPV) posttreatment, the risk of CIN 2+ was 0.69% (95% CI = 0.3%-1.5%); among individuals testing positive for HPV posttreatment, the risk of CIN 2+ was 18.3% (95% CI = 12.1%-26.6%) in all studies. All risk estimates were substantially higher for liquid-based cytology. The HPV-cytology co-testing provided slightly better reassurance compared with HPV alone at the cost of much higher positivity. CONCLUSIONS:Despite a large number of published studies on postcolposcopy and posttreatment surveillance, only few met criteria for abstraction and were included in the meta-analysis. More high-quality studies are needed to evaluate assays and approaches that can improve management of patients with abnormal screening.
journal_name
J Low Genit Tract Disjournal_title
Journal of lower genital tract diseaseauthors
Clarke MA,Unger ER,Zuna R,Nelson E,Darragh TM,Cremer M,Stockdale CK,Einstein MH,Wentzensen Ndoi
10.1097/LGT.0000000000000526subject
Has Abstractpub_date
2020-04-01 00:00:00pages
148-156issue
2eissn
1089-2591issn
1526-0976pii
00128360-202004000-00006journal_volume
24pub_type
杂志文章,meta分析abstract:OBJECTIVE:The natural evolution of atypical glandular cells of undetermined significance (AGUS) within a dysplasia clinic population has not yet been studied. The purpose of this study was to determine the outcome of cervico-vaginal smears with the diagnosis of AGUS from dysplasia clinic patients. MATERIAL AND METHODS...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199810000-00001
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:The aims of the study were to assess the clinical and histopathological characteristics of a comprehensive cohort of women with vulvovaginal melanoma (VVM) treated at our institution and to study the treatment response of checkpoint inhibitors in this patient cohort. MATERIALS AND METHODS:This is a retrospe...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000583
更新日期:2020-11-24 00:00:00
abstract:BACKGROUND:Massive localized lymphedema (MLL) is a recently described entity associated with obesity, most often on the thighs. It rarely occurs on the vulva, and it may pose diagnostic difficulty for both clinician and pathologist in this setting. CASE:An obese 55-year-old woman underwent excision of bilateral polypo...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0b013e31829cf432
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:To determine whether there is an association between high levels of telomerase and premalignant cervical disease and to provide a preliminary analysis of telomerase activity as a potential triage strategy. MATERIALS AND METHODS:Premenopausal women were invited to participate in the study during routine gyne...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200504000-00005
更新日期:2005-04-01 00:00:00
abstract::To document the first reported synchronous occurrence of Hodgkin lymphoma and adenosquamous carcinoma involving the female genital tract. Review of cytologic, histologic, and immunohistochemical studies obtained from a 50-year-old, multiparous, postmenopausal, Hispanic female who had a left inguinal mass, bilateral lo...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200310000-00015
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To compare the results of cold knife conization (CKC) and loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia to determine if excisional method has effects on pathologic interpretation. METHODS:Retrospective review of the perioperative medical records of patients who had a C...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31817ff940
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:The objective of this multicenter trial was to determine the incidence of human papillomavirus (HPV) in the amniotic fluid of pregnant patients. METHODS:Fifty-three pregnant patients undergoing genetic counseling or amniocentesis for preterm labor were entered into the study. Cervical swabs and amniotic flu...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199807000-00008
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:This study aimed to report 2 cases of squamous cell carcinoma (SCC) of the vulva, arising from unusual subepithelial locations. MATERIALS AND METHODS:The first case was of an 85-year-old woman with a 65-year history of a mass in the left labium majus. The second case was of a 54-year-old woman who presented ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31827a8c95
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:The aims of the study were to define the heterogeneity of vulvodynia by determining data-driven subgroups within the vulvodynia diagnosis using exploratory cluster analysis and to characterize the subgroups identified. MATERIALS AND METHODS:Included were participants in the longitudinal population-based stud...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000166
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:: Lack of estrogen after menopause can cause many changes in the lower genital tract of women, including involution of the introitus and collapse of the vestibule into the genital cleft. CASES:: Six cases of hypoestrogenic women are described, with the unusual finding of entrapment of terminal hairs between...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31821a68a5
更新日期:2011-10-01 00:00:00
abstract::Cavernous hemangiomas of the cervix are extremely rare, benign lesions. To date, fewer than 50 cases have been reported. Here reported is a case of cavernous hemangioma of the cervix in a 53-year-old patient with the complaint of postcoital spotting. Most of these lesions are asymptomatic incidental findings, but some...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000210120.78145.b8
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:To report the outcome of patients diagnosed with cervical intraepithelial neoplasia 2, 3 (CIN 2, 3) during pregnancy, who were treated by large loop excision of the transformation zone (LLETZ) in the first trimester or were followed up conservatively and treated after delivery. METHODS:Patients diagnosed wi...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318299c0af
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the clinical significance of the two subgroups of atypical squamous cells of undetermined significance (ASCUS), designated "favor reactive" and "favor preneoplastic." MATERIALS AND METHODS:Cervical Papanicolaou smears with a diagnosis of ASCUS favor reactive or ASCUS favor preneoplas...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199707000-00006
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:The authors' objective was to determine retrospectively the methods used to follow up atypical glandular cells of undetermined significance (AGUS) on Papanicolaou smears and to evaluate the effectiveness of those methods. MATERIAL AND METHODS:The charts of all patients with AGUS smears obtained between Febr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199704000-00007
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the ability of collecting the Affirm VP-III test sample using the residual vaginal discharge found on the speculum. METHODS AND METHODS:One hundred nine symptomatic women (≥18 y) participated in this study. During pelvic examination, vaginal fluid was collected onto 3 swabs for office-based diagn...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000025
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To quantify the coverage and monitor the factors associated with opportunistic cervical cytological screening in Spain. MATERIALS AND METHODS:Population-based survey of selected women through the Access Panel technique representative of the general population. A total of 6,852 women (60%) replied to the ques...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181599c16
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The molecular events surrounding the pathogenesis of human cervical cancer remain to be defined to a significant extent. The current study investigates the expression of two putative tumor suppressor genes p16 and Rb in cervical neoplasm. MATERIALS AND METHODS:Tissue was collected from 16 cervical intraepit...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199710000-00008
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify the clinicopathologic features and treatment outcome of primary extramammary Paget disease of the vulva (EMPDV). MATERIALS AND METHODS:We performed a retrospective analysis of 14 patients who were treated at our center from April 1994 to November 2010. RESULTS:The mean ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000063
更新日期:2015-04-01 00:00:00
abstract::Giant condyloma acuminatum is a large, slow-growing, exophytic, cauliflower-like tumor of the external genitalia. It is a histologically benign lesion, largely associated with human papillomavirus infection but with a high recurrence rate. The main differential diagnosis includes verrucous carcinoma. Differentiation b...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181c945ed
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to demonstrate a methodology for auditing the impact of HCII testing on the direct cost of cervical cancer cytological screening, where the test is collected in all women screened and processed routinely in women age 30 years and older. MATERIALS AND METHODS:After a policy chang...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318057f319
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate and compare the diagnostic yield of conventional endocervical curettage (ECC) with fabric-based ECC in a consistent physician group. MATERIALS AND METHODS:This is a retrospective case-control study of patients who underwent ECC both before and after introduction of a fabr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000324
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Visual assessment of digitized cervigrams through the Internet needs to be optimized. The National Cancer Institute and National Library of Medicine are involved in a large effort to improve colposcopic assessment and, in preparation, are conducting methodologic research. MATERIALS AND METHODS:We selected 50...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000192696.93172.ae
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:Allergic contact dermatitis is an uncommon but important cause of skin disease in the anogenital region. Relevant allergens are described in women and less commonly in men. The aim of this study was to describe outcomes of patch testing in men and women presenting with anogenital dermatoses. MATERIALS AND M...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000516
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To determine if sites selected for colposcopic biopsy and histologically proven cervical intraepithelial neoplasia are distributed randomly across the cervix. MATERIALS AND METHODS:Data were evaluated from all patients who visited the Walter Reed Army Medical Center Colposcopy Clinic during a 20-month period...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200501000-00008
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to conduct a representative survey of human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the United States. MATERIALS AND METHODS:Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana, and Michi...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31827ed372
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess clinical and histopathologic characteristics of symptomatic women who underwent a nondiagnostic biopsy of the inner vulva. MATERIALS AND METHODS:Consecutive nondiagnostic biopsies from medial labia minora, posterior fourchette, and vestibule obtained from symptomatic women ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000366
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Bacterial vaginosis (BV) is a common cause of genital discomfort in women in reproductive ages, which causes many complications. Bacterial vaginosis is usually treated by metronidazole and clindamycin. However, this protocol does not prevent its recurrence, which is a main complaint of the patients. The numbe...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0b013e31829156ec
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HP...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000573
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing. MATE...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000497
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To determine the validity of the Papanicolaou smear in the diagnosis of bacterial vaginosis, Trichomonas vaginalis, and Candida spp. MATERIALS AND METHODS:We determined the sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears we performed in 824 symptomatic patient...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00