The evaluation of human papillomavirus DNA testing in primary screening for cervical lesions in a large Japanese population
The evaluation of human papillomavirus DNA testing in primary screening for cervical lesions in a large Japanese population
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DOI：
10.1111/j.1525-1438.2006.00460.x
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发表时间：
2006-05-01
影响因子：
4.8
通讯作者：
Tango, M.
中科院分区：
文献类型：
--
作者：
Inoue, M.;Sakaguchi, J.;Tango, M.
为了检验人乳头瘤病毒 (HPV) DNA 检测在宫颈癌及其癌前病变筛查中的效用，开展了一项前瞻性队列研究，纳入了 8156 名中位年龄为 36 岁的女性。从子宫颈刮取的两份涂片样本用于巴氏试验和 HPV DNA 检测（混合捕获-II 系统）。使用 DNA 微阵列芯片进一步检查 HPV 阳性样本的 HPV 亚型。细胞学异常或具有高危HPV DNA的女性通过阴道镜进一步检查以确定组织学诊断。在 11% 的总人口中检测到高危 HPV DNA，其中特定类型的患病率较高，包括 52、16、58、51、56 和 18。正如预期的那样，年轻女性的 HPV 感染频率可能会增加。值得注意的是，HPV DNA 检测检测出所有 45 例宫颈上皮内瘤变 (CIN) 3，而其中 6 例细胞学检查结果呈阴性。特别有趣的是，CIN 通常与多种 HPV 类型相关，而侵袭性癌症则只有单一类型的 HPV。就检测 CIN 的敏感性和阳性预测值而言，HPV DNA 检测优于细胞学检测。然而，最重要的是，HPV DNA 检测与细胞学相结合显着提高了 CIN 筛查的效果。
To examine the utility of human papillomavirus (HPV) DNA testing for the screening of cervical cancer and its precursors, a prospective cohort study was performed in which a total of 8156 women with a median age of 36 years were enrolled. Two smear samples scraped from the uterine cervix were served for Papanicolaou test and HPV DNA testing (Hybrid Capture-II system). HPV-positive samples were further examined for HPV subtype using a DNA microarry chip. Women with cytologic abnormality or those with high-risk HPV DNA were further examined by colposcopy to determine histologic diagnosis. High-risk HPV DNA was detected in 11% of the general population, with higher prevalence of specific types, including 52, 16, 58, 51, 56, and 18. As expected, younger women were likely to have increased frequency of HPV infection. Notably, HPV DNA testing detected all 45 cases of cervical intraepithelial neoplasia (CIN) 3, while cytologic findings were negative in 6 of these cases. It is of particular interest that CIN was commonly associated with multiple HPV types, while invasive cancers had a single type of HPV. In terms of both sensitivity and positive predictive value in detecting the CIN, HPV DNA testing is superior to cytology. However, most importantly, HPV DNA testing in combination with cytology significantly improved the efficacy to CIN screening.