Performance of combined liquid based cytology and HPV nucleic acid test for detecting cervical precancer among women attending screening
10.3760/cma.j.issn.0253-3766.2018.10.006
- VernacularTitle: 液基细胞学联合人乳头状瘤病毒核酸检测对宫颈癌筛查的效果评价
- Author:
Mingyue JIANG
1
;
Ruimei FENG
2
;
Lin WANG
3
;
Tingyuan LI
1
;
Aiai ZHANG
4
;
Jianfeng CUI
1
;
Qinjing PAN
1
;
Xun ZHANG
5
;
Meili LIU
6
;
Feng GAO
7
;
Wen CHEN
1
;
Youlin QIAO
1
Author Information
1. Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2. Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
3. State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen 361102, China
4. Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian 116041, China
5. Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
6. Department of Obstetrics and Gynaecology, Hangjin Women and Children Health Care Center, Erdos 017400, China
7. Yijinhuoluo Women and Children Health Care Center and Family Planning Service Center, Erdos 017200, China
- Publication Type:Clinical Trail
- Keywords:
Human papillomavirus;
Genotyping;
Cytology;
Cervical screening
- From:
Chinese Journal of Oncology
2018;40(10):750-756
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical performance of HPV genotyping with cytology for detecting cervical precancer among women attending co-testing.
Methods:A total of 2 883 females who participated in cervical cancer screening program were recruited from Erdos in 2016. All the participants were tested by cytology and HPV genotyping. In 2017, women with abnormal cytology results or HPV positive were followed up. Pathological cervical intraepithelial neoplasia (CIN) 2+ was the study end-point. Clinical performance indexes were calculated, including sensitivity, specificity, positive predictive value, negative predictive value, referral rate and missed cases.
Results:INNO-LiPA resulted in a detection rate of 18.87%(544/2 883) for the 14-type high risk HPV. HPV16 was the most common infectious genotype (4.06%), followed by HPV52 (3.61%), HPV51 (2.50%), HPV58 (1.98%), and HPV18 (1.56%). With more HPV genotypes added into the group, sensitivity increased and the specificity decreased. Addition of HPV16, 58, 33, 39, 52, 18, 31 for detection lead to the maximun value of area under the curve (AUC)=0.913 (95%CI: 0.882-0.944). Compared with traditional screening method by cytology, cotesting decreased the number of missed diagnosis. Meanwhile, the fifth method (co-testing: triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities) did not increase referral rate (8.99% vs. 8.71%, P=0.525), with five cases of missed diagnosis (sensitivity of 92.1% and specificity of 93.2%).
Conclusions:Co-testing with triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities would provide better clinical performance. In co-testing, triage of HPV16/18 was used in women with normal cytology; triage of HPV58, 33, 39, 52 and 31 was used in women with low-grade abnormal cytology; referral colposcopy was used in women with high-grade abnormal cytology, which would provide better clinical performance.
