使用病毒载荷测试HPV阳性女性的证据:来自中国不同地区的两个大型队列查项目的数据
Yu Liu1, Wenkui Dai1, Hui Du1
1Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China; Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China; Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, China.
概括
基于病毒载量 (VL) 的分类有效地识别了人类乳头瘤病毒 (HPV) 阳性女性的宫癌前期和癌症. 这种方法可以改善查,其中细胞学是不可用的或不可靠的.
科学领域:
- 妇科 妇科 妇科 妇科
- 在瘤学瘤学.
- 病毒学 病毒学
背景情况:
- 宫癌查依赖于人类乳头瘤病毒 (HPV) 测试,随后通常是基于细胞学对HPV阳性个体的分类.
- 目前的选策略可能涉及多次访问,并且可能受到细胞学服务的可用性和可靠性的限制.
研究的目的:
- 评估基于病毒载量 (VL) 的选策略对HPV阳性女性的有效性.
- 以使用HPVDNA水平 (周期值[Ct]值) 进行基于VL的选,与指南推的基于细胞学的选进行比较.
主要方法:
- 从25419名查参与者中分析了1656例HPV阳性病例.
- 两种分类策略的比较: (1) HPV类型和Ct值截止值 (第75百分位),和 (2) HPV类型和细胞学 (≥不典型的未确定意义的状细胞[ASCUS]).
- 评估结果包括2级或更严重的宫内皮质瘤 (CIN2+) 和CIN3+检测率.
主要成果:
- 基于VL的策略 (HPV-16/18和其他类型的Ct≤75百分位数) 显示,与细胞学 (85.27%,p=0.016) 相比,CIN2+检测 (91.52%) 的灵敏度更高.
- 对于CIN3+检测的灵敏度在基于VL的分组 (95.60%) 和细胞学 (96.70%,p=1.000) 之间是可比的.
- 使用Ct≤75百分位数的HPV-16/18和其他Ct≤75百分位数的HPV类型的策略也显示了对CIN2+和CIN3+检测与细胞学检测的敏感性相似.
结论:
- 基于病毒载荷的分类对在HPV阳性个体中识别子宫前癌和癌症是有效的.
- 这种方法允许采集单个样本,从而可能减少患者访问.
- 基于VL的分组是一种有前途的替代方案,特别是在细胞学资源有限的环境中,尽管它可能会增加镜转诊.
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