Posttreatment human papillomavirus testing for residual or recurrent high-grade cervical intraepithelial neoplasia: a pooled analysis / 부인종양
Journal of Gynecologic Oncology
; : e3-2016.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-21465
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE:
We conducted a pooled analysis of published studies to compare the performance of human papillomavirus (HPV) testing and cytology in detecting residual or recurrent diseases after treatment for cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3).METHODS:
Source articles presenting data on posttreatment HPV testing were identified from the National Library of Medicine (PubMed) database. We included 5,319 cases from 33 articles published between 1996 and 2013.RESULTS:
The pooled sensitivity of high-risk HPV testing (0.92; 95% confidence interval [CI], 0.90 to 0.94) for detecting posttreatment CIN 2 or worse (CIN 2+) was much higher than that of cytology (0.76; 95% CI, 0.71 to 0.80). Co-testing of HPV testing and cytology maximized the sensitivity (0.93; 95% CI, 0.87 to 0.96), while HPV genotyping (detection of the same genotype between pre- and posttreatments) did not improve the sensitivity (0.89; 95% CI, 0.82 to 0.94) compared with high-risk HPV testing alone. The specificity of high-risk HPV testing (0.83; 95% CI, 0.82 to 0.84) was similar to that of cytology (0.85; 95% CI, 0.84 to 0.87) and HPV genotyping (0.83; 95% CI, 0.81 to 0.85), while co-testing had reduced specificity (0.76; 95% CI, 0.75 to 0.78). For women with positive surgical margins, high-risk HPV testing provided remarkable risk discrimination between test-positives and test-negatives (absolute risk of residual CIN 2+ 74.4% [95% CI, 64.0 to 82.6] vs. 0.8% [95% CI, 0.15 to 4.6]; p<0.001).CONCLUSION:
Our findings recommend the addition of high-risk HPV testing, either alone or in conjunction with cytology, to posttreatment surveillance strategies. HPV testing can identify populations at greatest risk of posttreatment CIN 2+ lesions, especially among women with positive section margins.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Papillomaviridae
/
Displasia do Colo do Útero
/
Neoplasias do Colo do Útero
/
Valor Preditivo dos Testes
/
Sensibilidade e Especificidade
/
Medição de Risco
/
Neoplasia Residual
/
Infecções por Papillomavirus
/
Recidiva Local de Neoplasia
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Journal of Gynecologic Oncology
Ano de publicação:
2016
Tipo de documento:
Artigo