Human papillomavirus testing for primary screening of cervical cancer precursors.
Human papillomavirus testing for primary screening of cervical cancer precursors.
复制标题
人乳头瘤病毒检测用于宫颈癌前兆的初步筛查。
DOI：
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
A. Ferenczy
中科院分区：
文献类型：
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作者：
S. Ratnam;E. Franco;A. Ferenczy
我们的目的是确定是否增加了人乳头瘤病毒（HPV）检测，以筛查细胞学提高检测宫颈癌的前兆。在加拿大纽芬兰的一项多中心研究中，18-69岁的妇女接受了常规巴氏细胞学和HPV DNA检测。细胞学和/或HPV阳性的患者和双阴性结果的随机样本被推荐进行阴道镜检查。该研究招募了2098名女性。对于所有级别的鳞状上皮内病变[锡尔斯; 73%; 95%置信区间（CI），62-82]和高级别锡尔斯（HSIL; 90%; 95% CI，74-97），HPV检测的相对灵敏度显著高于细胞学，但相对特异性（所有级别锡尔斯为62%，HSIL为51%）低于大多数细胞学临界点。HPV检测的所有级别病变的综合正确结果率（68.8%）高于任何细胞学临界点（可疑，52.3%; LSIL，51.6%; HSIL，44.5%）。HPV和LSIL临界点的组合对所有锡尔斯的阴性预测值为68%（95%CI，52-80），对HSIL的阴性预测值为100%（95%CI，91-100），而阴道镜检查仅涉及12%的女性。我们的结论是，HPV检测与细胞学检查相结合，提高了单独细胞学检查的筛查效果，并可能允许一个更有效，更安全的初级筛查计划，增加筛查间隔。
Our objective was to determine whether the addition of human papillomavirus (HPV) testing to screening cytology improves the detection of cervical cancer precursors. Women of ages 18-69 years underwent conventional Pap cytology and HPV DNA testing in a multicenter study in Newfoundland, Canada. Those with positive cytology and/or HPV and a random sample of those with dual negative results were referred for colposcopy. The study enrolled 2098 women. The relative sensitivity of HPV testing was significantly higher than cytology for all-grade squamous intraepithelial lesions [SILs; 73%; 95% confidence interval (CI), 62-82] and high grade SILs (HSILs; 90%; 95% CI, 74-97) but had lower relative specificity (62% for all-grade SILs and 51% for HSILs) than most cytological cutpoints. The rate of combined correct results for all-grade lesions was higher for HPV testing (68.8%) than for any cytological cutpoint (equivocal, 52.3%; LSILs, 51.6%; HSILs, 44.5%). The combination of HPV and an LSIL cutpoint had a negative predictive value of 68% (95% CI, 52-80) for all SILs and 100% (95% CI, 91-100) for HSILs, while referring for colposcopy only 12% of the women. We concluded that HPV testing in conjunction with cytology improved the screening efficacy of cytology alone and may allow for a more effective and safe primary screening program with increased screening intervals.
影响因子：
120.7
作者：
Schiffman, M;Herrero, R;Lorincz, AT
通讯作者：
Lorincz, AT
影响因子：
10.3
作者：
HO, GYF;BURK, RD;ROMNEY, S
通讯作者：
ROMNEY, S