Cross-sectional study of patient- and physician-collected cervical cytology and human papillomavirus
Cross-sectional study of patient- and physician-collected cervical cytology and human papillomavirus
复制标题
DOI：
10.1016/s0029-7844(03)00517-9
复制
发表时间：
2003-08-01
影响因子：
7.2
通讯作者：
Davis, J
中科院分区：
文献类型：
--
作者：
Garcia, F;Barker, B;Davis, J
目的：比较患者和医生获得的细胞学和人乳头瘤病毒 (HPV) 检测在检测高级别宫颈上皮内瘤变方面的表现。 方法：对在三个阴道镜诊所（亚利桑那州图森、墨西哥埃莫西约和秘鲁利马）就诊的 334 名女性进行了一项横断面研究。所有女性均使用细胞刷自行采集样本进行宫颈细胞学检查和 HPV 检测。随后，受试者接受医生采集细胞学和 HPV 检测，然后进行完整的阴道镜评估和定向活检。使用薄层技术进行细胞学检查，并使用聚合酶链式反应技术测定HPV。使用组织病理学诊断作为参考标准，并将高级别宫颈上皮内瘤变指定为具有临床意义的疾病，以进行分析。结果：患者收集的细胞学检查的敏感性显着较低（55.0％），特异性显着优于医生指导取样（分别为85.2％和73.4％）（分别为85.2％和73.4％）。患者采集的 HPV 的敏感性 (49.0%) 显着低于医生采样 (82.2%)，但特异性没有显着差异。 结论：患者采集是一种可行的替代方案，尽管效果比医生采集的宫颈细胞学和 HPV 检测较差。
OBJECTIVE: To compare the performance of patient- and physician-obtained cytology and human papillomavirus (HPV) testing for the detection of high-grade cervical intraepithelial neoplasia.METHODS: A cross-sectional study was performed involving 334 women seen at three colposcopy clinics (Tucson, Arizona; Hermosillo, Mexico; and Lima, Peru). All women used a cytobrush to self-collect specimens for cervical cytology and HPV testing. Subjects subsequently underwent physician collection for cytology and HPV, followed by a complete colposcopic evaluation with directed biopsy. Cytology was processed using thin-layer technology, and HPV was determined using the polymerase chain reaction technique. Test performance characteristics were determined using the histopathologic diagnosis as the reference standard and designating high-grade cervical intraepithelial neoplasia as clinically significant disease for the purpose of the analysis.RESULTS: The sensitivity of patient-collected cytology was significantly lower (55.0%) and specificity was significantly better (84.1%) than those of physician-directed sampling (85.2% and 73.4%, respectively). Patient-collected HPV had significantly lower sensitivity (49.0%) than physician sampling (82.2%), although specificity did not significantly differ.CONCLUSION: Patient collection is a feasible although inferior alternative to physician-collected cervical cytology and HPV testing.