Performance of human papillomavirus E6/E7 mRNA assay for primary cervical cancer screening and triage: Population-based screening in China.
Front Cell Infect Microbiol
; 12: 935071, 2022.
Article
em En
| MEDLINE
| ID: mdl-36105144
ABSTRACT
Objective:
Cervical cancer screening is very important in the prevention and treatment of cervical cancer. In China, the cervical screening strategy needs to be improved. To explore a suitable cervical screening strategy in China, we evaluated the performance of the human papillomavirus (HPV) E6/E7 mRNA (Aptima HPV (AHPV)) assay in primary screening and different triage strategies for women undergoing routine cervical screening.Methods:
A total of 10,002 women aged 35 to 65 years of age were recruited in Liaoning Province and Qingdao City, China. Specimens were tested by liquid-based cytology (LBC) and the AHPV assay, and women who tested positive on any test were referred for colposcopy. Genotyping was performed on all high-risk HPV (HR-HPV)-positive samples. Test characteristics were calculated based on histological review.Results:
We identified 109 women with high-grade squamous intraepithelial lesion or worse (HSIL+), including six with cervical cancer. The sensitivity of AHPV was clearly higher than that of LBC (92.7 [95% CI 87.2, 97.2] vs. 67.9 [95% CI 59.6, 76.1], p < 0.001). The specificity of AHPV was 93.0 (95% CI 92.5, 93.5), which was lower than that of LBC (95.2 [95% CI 94.8, 95.6], p < 0.001). There was no statistical difference between the positive predictive value of AHPV and LBC (13.5 [95% CI 11.2, 16.2] vs. 14.3 [95% CI 11.4, 17.6], p = 0.695). The difference of area under the curve (AUC) values between the AHPV test (0.928 [95% CI 0.904, 0.953]) and LBC test (0.815 [95% CI 0.771, 0.860]) in detecting HSIL+ was statistically significant (p < 0.001). Finally, among the three triage strategies, both the sensitivity (73.4 [95% CI 65.1, 81.7]) and AUC (0.851 [95% CI 0.809, 0.892]) of AHPV genotyping with reflex LBC triage were the greatest.Conclusion:
In summary, the AHPV assay is both specific and sensitive for detecting HSIL+ and may be suitable for use in primary cervical cancer screening in China. AHPV genotyping with reflex LBC triage may be a feasible triage strategy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Saude_da_mulher
/
Colo_do_utero
/
Tipos_de_cancer
/
Colo_do_utero
/
Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
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Infecções por Papillomavirus
/
Alphapapillomavirus
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Adult
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Aged
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Female
/
Humans
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Front Cell Infect Microbiol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
China