Performance of careHPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania: A cross-sectional study
Performance of careHPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania: A cross-sectional study
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DOI：
10.1371/journal.pone.0218559
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发表时间：
2019-06-19
期刊：
影响因子：
3.7
通讯作者：
Rasch, Vibeke
中科院分区：
文献类型：
--
作者：
Katanga, Johnson;Kjaer, Susanne K.;Rasch, Vibeke
目的比较careHPV、HybridCapture 2（HC 2）和醋酸目视检查（VIA）检测细胞学诊断的高级别宫颈病变或宫颈癌（HSIL+）的效果。坦桑尼亚.PopulationWomen attending routine cervical cancer screening.MethodWe enrolled 4080 women（25-60 years）in the study.这些妇女接受了关于生活方式习惯的采访，并接受了艾滋病毒检测。在妇科检查时获得用于careHPV检测的宫颈标本（在ORCI和KCMC进行）、用于使用HC 2进行HPV DNA检测的液基细胞学样本（在德国Tuebingen大学医院进行）和用于细胞学评估的液基细胞学样本（在丹麦Vejle医院进行）。随后，进行了VIA。以细胞学为金标准，敏感性和特异性的careHPV，HC 2，和VIA检测HSIL+ calculated.ResultsAltogether，23.6%有一个积极的careHPV测试，19.1%有积极的HC 2测试，和6.3%有积极的VIA测试。careHPV的敏感性/特异性为88.9%/78.9%，HC 2为91.1%/83.7%。VIA检测HSIL+的敏感性较低（31.1%），但特异性较高（94.6%）。careHPV、HC 2和VIA的敏感性在年轻女性和HIV阳性女性中较高。结论宫颈癌高危人群中，宫颈癌高危人群中，宫颈癌高危必须确定合适的分类测试。
ObjectiveTo examine the test performance of careHPV, Hybrid Capture2 (HC2) and visual inspection with acetic acid (VIA) for detection of cytologically diagnosed high-grade cervical lesions or cancer (HSIL+).DesignCross-sectional study.SettingOcean Road Cancer Institute (ORCI) and Kilimanjaro Christian Medical Center (KCMC), Tanzania.PopulationWomen attending routine cervical cancer screening.MethodWe enrolled 4080 women (25-60 years) in the study. The women were interviewed on life-style habits, and tested for HIV. A cervical specimen for careHPV testing (performed at ORCI and KCMC), and a liquid-based cytology sample for HPV DNA detection using HC2 (performed at Tuebingen University Hospital, Germany) and for cytology assessment (performed at Vejle Hospital, Denmark) were obtained at a gynecological examination. Subsequently, VIA was performed. With cytology as gold standard, the sensitivity and specificity of careHPV, HC2, and VIA for detection of HSIL+ were calculated.ResultsAltogether, 23.6% had a positive careHPV test, 19.1% had positive HC2 test, and 6.3% had a positive VIA test. The sensitivity/specificity was 88.9%/78.9% for careHPV and 91.1%/83.7%, for HC2. VIA showed a low sensitivity of 31.1% but a high specificity (94.6%) for detection of HSIL+. The sensitivity of careHPV, HC2 and VIA was higher among younger women, and among HIV positive women. VIA triage of careHPV positive women improved specificity, but sensitivity dropped to 27%.ConclusionOur results confirm the low sensitivity of VIA for detection of HSIL+ and further document that careHPV test is promising as a primary screening method for cervical-cancer prevention in low-resource regions. A suitable triage test has to be identified.