Performance of Xpert HPV on Self-collected Vaginal Samples for Cervical Cancer Screening Among Women in South Africa.
Performance of Xpert HPV on Self-collected Vaginal Samples for Cervical Cancer Screening Among Women in South Africa.
复制标题
XPERT HPV在南非女性中进行宫颈癌筛查的自我收集的阴道样品的性能。
DOI：
10.1097/lgt.0000000000000575
复制
发表时间：
2021-01-01
影响因子：
3.7
通讯作者：
Denny L
中科院分区：
文献类型：
--
作者：
Saidu R;Kuhn L;Tergas A;Boa R;Moodley J;Svanholm-Barrie C;Persing D;Campbell S;Tsai WY;Wright TC;Denny L
Self-sampling may increase access to cervical cancer screening in low resource settings. Using Xpert HPV, we compared test performance of self- and clinician-collected samples in HIV-positive and HIV-negative women in South Africa. 330 HIV-positive and 375 HIV-negative women in the screening group and 202 HIV-negative and 200 HIV-positive women in the referral group, aged 30–65 years participated in the study. All women self-collected a vaginal sample, then a cervical sample collected by a clinician (both tested using Xpert HPV), followed by colposcopic examination and collection of histologic specimens. There was good agreement between self-collected and clinician-collected samples for detection of any high-risk HPV (kappa=0.72 [95% CI: 0.669 – 0.771]). Prevalence of HPV and sensitivity of the test to detect CIN2+ was similar in self-collected and clinician-collected samples. Specificity was lower in self-collected than in clinician-collected samples in both HIV-negative (self: 77.5% [95% CI: 72.8 – 81.8] vs clinician: 86.9% [95% CI: 82.9 – 90.2]) and HIV-positive (self: 44.0% [95% CI: 38.0 – 50.1] vs clinician: 59.7% [95% CI: 53.6 – 65.6]) women. Restricting the definition of screen-positive to 3 of 5 channels on HPV Xpert improved specificity in both HIV-negative (self: 83.2% [95% CI: 78.8 – 87.0 ] [self] vs clinician: 89.7% [95% CI: 86.1 – 92.7]) and HIV-positive (self: 54.2% [95% CI 48.1 – 60.2] vs clinician: 67.4% [95% CI: 61.5 – 72.9]) women. The self-collected sample had good agreement with the clinician-collected sample for the detection of HPV and restricting the HPV-types may improve the specificity in HIV-positive women. For detection of HPV, self-sample is comparable with clinician-sample, but in HIV-positive women, further triage may be required to confirm diagnosis due to lower specificity.
