Management of women who test positive for high-risk types of human papillomavirus: the HART study
Management of women who test positive for high-risk types of human papillomavirus: the HART study
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DOI：
10.1016/s0140-6736(03)14955-0
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发表时间：
2003-12-06
期刊：
影响因子：
168.9
通讯作者：
Sasieni, P
中科院分区：
文献类型：
--
作者：
Cuzick, J;Szarewski, A;Sasieni, P
背景：某些类型的人乳头瘤病毒(HPV)是几乎所有宫颈癌的主要原因。宫颈涂片HPV检测比细胞学检测宫颈上皮内瘤变(CIN2+)更敏感，但特异性较低。HPV检测作为一种主要筛查方法，需要对细胞学阴性或边缘阳性的HPV阳性妇女进行有效的管理。我们的目的是比较人乳头瘤病毒检测和细胞学检测的阳性预测值和检出率，并确定对HPV阳性妇女的最佳处理策略。方法我们对11085名30-60岁的妇女进行了多中心筛查研究。结果发现HPV检测比临界细胞学检查更敏感(97.1%比76.6%，p=0002)，但特异性较差(93.3%比95.8%，p=0002)。
Background Certain types of human papillomavirus (HPV) are the primary cause of almost all cervical cancers. HPV testing of cervical smears is more sensitive but less specific than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN2+). HPV testing as a primary screening approach requires efficient management of HPV-positive women with negative or borderline cytology. We aimed to compare the detection rate and positive predictive values of HPV assay with cytology and to determine the best management strategy for HPV-positive women.Methods We did a multicentre screening study of 11085 women aged 30-60 years. Women with borderline cytology and women positive for high-risk HPV with negative cytology were randomised to immediate colposcopy or to surveillance by repeat HPV testing, cytology, and colposcopy at 12 months.Findings HPV testing was more sensitive than borderline or worse cytology (97.1% vs 76.6%, p=0002) but less specific (93.3% vs 95.8%, p