Human papillomavirus mRNA and DNA testing in women with atypical squamous cells of undetermined significance: A prospective cohort study.
Int J Cancer
; 139(8): 1839-50, 2016 10 15.
Article
en En
| MEDLINE
| ID: mdl-27004595
ABSTRACT
In this prospective cohort study, we compared the performance of human papillomavirus (HPV) mRNA and DNA testing of women with atypical squamous cells of undetermined significance (ASC-US) during cervical cancer screening. Using a nationwide Danish pathology register, we identified women aged 30-65 years with ASC-US during 2005-2011 who were tested for HPV16/18/31/33/45 mRNA using PreTect HPV-Proofer (n = 3,226) or for high-risk HPV (hrHPV) DNA using Hybrid Capture 2 (HC2) (n = 9,405) or Linear Array HPV-Genotyping test (LA) (n = 1,533). Women with ≥1 subsequent examination in the register (n = 13,729) were followed for up to 9.5 years for high-grade cervical intraepithelial neoplasia (CIN) or cancer. After 3 years' follow-up, mRNA testing had higher specificity for CIN3 or worse (CIN3+) than HC2 testing (88.1% [95% confidence interval (CI) 86.8-89.6%] versus 59.3% [95% CI 58.1-60.4%]) and higher positive predictive value (PPV) (38.2% [95% CI 33.8%-43.1%] versus 19.5% [95% CI 17.8-20.9%]). However, the sensitivity of mRNA testing was lower than that of HC2 testing (66.7% [95% CI 59.3-74.5%] versus 97.0% [95% CI 95.5-98.4%]), and women testing mRNA negative had higher 3-year risk for CIN3+ than those testing HC2 negative (3.2% [95% CI 2.2-4.2%] versus 0.5% [95% CI 0.3-0.7%]). Patterns were similar after 18 months and 5 years'; follow-up; for CIN2+ and cancer as outcomes; across all age groups; and when comparing mRNA testing to hrHPV DNA testing using LA. In conclusion, the HPV16/18/31/33/45 mRNA test is not optimal for ASC-US triage due to its low sensitivity and the substantial risk for precancer following a negative test.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Papillomaviridae
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ADN Viral
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ARN Mensajero
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ARN Viral
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Infecciones por Papillomavirus
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Células Escamosas Atípicas del Cuello del Útero
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Int J Cancer
Año:
2016
Tipo del documento:
Article
País de afiliación:
Dinamarca