关键词: Cervical pathology Gynecologic pathology LAST guidelines p16

Mesh : Biomarkers, Tumor / analysis Cervical Intraepithelial Neoplasia / virology Cyclin-Dependent Kinase Inhibitor p16 / analysis Female Guideline Adherence / statistics & numerical data Humans Papillomavirus Infections / diagnosis Practice Guidelines as Topic Uterine Cervical Neoplasms / virology

来  源:   DOI:10.1309/AJCPUXLP7XD8OQYY

Abstract:
OBJECTIVE: To determine the impact of implementing p16 Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions (LAST) guidelines, we compared p16 use and follow-up data before and after implementation of the guidelines.
METHODS: We reviewed all cervical biopsy specimens diagnosed by two pathologists before and after implementation of the LAST guidelines and calculated the rate of and reason for p16 use across all biopsy specimens, high-grade squamous intraepithelial lesion (HSIL) detection, and follow-up.
RESULTS: In total, 1,829 and 1,623 cervical biopsy specimens were reviewed in periods A and B, respectively. Overall p16 use increased from 2.8% to 6.2% (P < .001). Recommendations 2 and 4 increased from 0.16% and 0% of all cervical biopsy specimens in period A to 1.4% and 1.9% in period B, respectively (P < .0001). p16+ HSIL increased from 1.4% to 2.3% (P < .05). The positive predictive value of p16+ HSIL increased from 48% to 76% (P < .05).
CONCLUSIONS: Implementation of the p16 LAST guidelines resulted in a significant increase in p16 use and a significant increase in the positive predictive value of p16+ HSIL.
摘要:
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