Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16(INK4a)/Ki-67 dual stain cytology in Western Kenya.
Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16(INK4a)/Ki-67 dual stain cytology in Western Kenya.
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DOI：
10.1186/s13027-020-00323-6
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发表时间：
2020
影响因子：
3.7
通讯作者：
Bussmann H
中科院分区：
文献类型：
--
作者：
Orang'o EO;Were E;Rode O;Muthoka K;Byczkowski M;Sartor H;Vanden Broeck D;Schmidt D;Reuschenbach M;von Knebel Doeberitz M;Bussmann H
对未接种疫苗的女性进行筛查对于降低宫颈癌的高发病率/死亡率仍然至关重要。在这里，我们将世界卫生组织推荐的醋酸目视检查（VIA）作为中低收入国家最具成本效益的筛查方法，与基于 HPV 的筛查以及 p16INK4a/Ki-67 双染色细胞学的使用进行了比较。我们前瞻性地招募了参与肯尼亚两个城郊卫生中心基于 VIA 的宫颈癌筛查项目的女性。同意的女性进行 VIA 检查，然后从宫颈收集液基细胞学样本，保存在 PreservCyt 培养基 (Hologic®) 中。所有样本的分析包括 hrHPV DNA 测试和 p16INK4a /Ki-67 (CINtecPLUS®) 双染色载玻片的评估，该载玻片使用 ThinPrep® 2000 处理器制备，并由经过该方法培训的病理学家进行评估。对总共 800 名 18-64 岁女性中的 701 名进行了所有三项调查并对数据进行了分析。 HPV、VIA 和双重染色细胞学阳性率分别为 33%、7% 和 2%。 VIA阳性病例的HPV阳性率为32%。五种最常见的 HPV 类型为 HPV16、52、68、58 和 35。HIV 感染女性中 HPV 感染、VIA 阳性和双染细胞学阳性的 OR 分别为 2.6 (95% CI 1.5–4.3)、1.9 (95% CI 0.89–4.4) 和 3.4 (95% CI 1.07–10.9)。 VIA 检测 p16INK4a/Ki-67 阳性转化感染的敏感性为 13% (95%CI 2-38)。初级 HPV 检测似乎可行，也应被视为中低收入国家的初级筛查检测。 VIA 的敏感性较差，因此不适合作为 HPV 阳性女性的分类测试。应进一步研究 p16INK4a/Ki-67 双染色细胞学作为中低收入国家 HPV 阳性女性分流测试的实用性。
Screening of unvaccinated women remains essential to mitigate the high morbidity/mortality of cervical cancer. Here, we compared visual inspection with acetic acid (VIA), recommended by WHO as the most cost-effective screening approach in LMICs, with HPV-based screening, and usage of p16INK4a/Ki-67 dual stain cytology. We prospectively enrolled women participating in a VIA-based cervical cancer screening program in two peri-urban health centers of Kenya. Consenting women had a VIA examination preceded by collection of a liquid-based cytology sample from the cervix stored in PreservCyt medium (Hologic®). Analysis of all samples included a hrHPV DNA test and evaluation of a p16INK4a /Ki-67 (CINtecPLUS®) dual stained slide that was prepared using the ThinPrep® 2000 Processor and evaluated by a pathologist trained in the methodology. In 701 of a total of 800 women aged 18–64 years, all three investigations were performed and data could be analyzed. The HPV, VIA and dual stain cytology positivity were 33%, 7%, and 2% respectively. The HPV positivity rate of VIA positive cases was 32%. The five most common HPV types were HPV16, 52, 68, 58 and 35. The OR among HIV infected women of an HPV infection, VIA positivity and positive dual stain cytology were 2.6 (95%CI 1.5–4.3), 1.9 (95%CI 0.89–4.4) and 3.4 (95%CI 1.07–10.9) respectively. The sensitivity of VIA to detect a p16INK4a/Ki-67 positive transforming infection was 13% (95%CI 2–38). Primary HPV testing appears feasible and should be considered as a primary screening test also in LMICs. The poor sensitivity of VIA renders it unsuitable as a triage test for HPV positive women. The utility of p16INK4a/Ki-67 dual stain cytology as a triage test for HPV positive women in LMICs should be further studied.
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影响因子：
4.7
作者：
Dona, Maria Gabriella;Vocaturo, Amina;Benevolo, Maria
通讯作者：
Benevolo, Maria
影响因子：
105.7
作者：
Dijkstra, Maaike G.;van Zummeren, Marjolein;Berkhof, Johannes
通讯作者：
Berkhof, Johannes
DOI：
10.1097/igc.0b013e318280f395
发表时间：
2013-03-01
影响因子：
4.8
作者：
Ajenifuja, Kayode Olusegun;Gage, Julia C.;Schiffman, Mark
通讯作者：
Schiffman, Mark
影响因子：
10.3
作者：
Denny, Lynette;Kuhn, Louise;Wright, Thomas C., Jr.
通讯作者：
Wright, Thomas C., Jr.
影响因子：
3.8
作者：
Basu, Partha;Meheus, Filip;Sankaranarayanan, Rengaswamy
通讯作者：
Sankaranarayanan, Rengaswamy