Xue Bai, Ya-Kun Liu, Ya-Jing Jia, Dao-Juan Li, Nai-Yi Du
{"title":"联合筛查和人乳头状瘤病毒 16 和 18 周期阈值对 CIN2+ 宫颈病变的诊断意义。","authors":"Xue Bai, Ya-Kun Liu, Ya-Jing Jia, Dao-Juan Li, Nai-Yi Du","doi":"10.2147/IJWH.S488125","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although both cervical intraepithelial neoplasia (CIN) II and CIN III carry the potential to progress into cervical cancer, to date, an optimal screening method for CIN2+ (CIN II, CIN III, and cervical cancer) cervical lesions is yet to be established.</p><p><strong>Methods: </strong>In this retrospective study, data from 2035 patients treated at the Fourth Hospital of Hebei Medical University between 2019 and 2021 were analyzed. The screening efficacy of three methods-the ThinPrep cytologic test (TCT) alone, the high-risk-human papillomavirus (HR-HPV) test alone, and the combined TCT and HR-HPV screening for CIN2+ lesions-were assessed using cervical histopathology as the reference standard. Additionally, correlations between HPV16 cycle threshold (Ct) values, HPV18 Ct values, and the severity of cervical lesions were analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic utility of HPV16 Ct values for CIN2+ lesions.</p><p><strong>Results: </strong>Compared with TCT or HR-HPV testing alone, the combined TCT and HR-HPV test had the highest sensitivity of 98.1% (<i>P</i> < 0.0001), the highest negative predictive value of 99.8% (<i>P</i> = 0.0001), and the lowest missed diagnosis rate of 1.9% (<i>P</i> < 0.0001) for screening CIN2+ lesions. Additionally, the combined test yielded the largest area under the ROC curve (AUC) value of 0.9480. There was a significant difference in HPV16 Ct values for various degrees of cervical lesions (<i>P</i> < 0.001), with the Spearman rank correlation test revealing a significant negative correlation (<i>rs</i> = -0.447, <i>P</i> < 0.001). The optimal HPV16 Ct value for diagnosing CIN2+ lesions was 29.995, with an AUC of 0.797 (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>The combination of TCT and HR-HPV testing was the most effective method for screening CIN2+ lesions. Furthermore, HPV16 Ct values were negatively correlated with the severity of cervical lesions, with a threshold of 29.995 potentially indicating the presence of CIN2+ lesions.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1959-1968"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587807/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Diagnostic Significance of Combined Screening and Human Papillomavirus 16 and 18 Cycle Threshold Values for CIN2+ Cervical Lesions.\",\"authors\":\"Xue Bai, Ya-Kun Liu, Ya-Jing Jia, Dao-Juan Li, Nai-Yi Du\",\"doi\":\"10.2147/IJWH.S488125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although both cervical intraepithelial neoplasia (CIN) II and CIN III carry the potential to progress into cervical cancer, to date, an optimal screening method for CIN2+ (CIN II, CIN III, and cervical cancer) cervical lesions is yet to be established.</p><p><strong>Methods: </strong>In this retrospective study, data from 2035 patients treated at the Fourth Hospital of Hebei Medical University between 2019 and 2021 were analyzed. The screening efficacy of three methods-the ThinPrep cytologic test (TCT) alone, the high-risk-human papillomavirus (HR-HPV) test alone, and the combined TCT and HR-HPV screening for CIN2+ lesions-were assessed using cervical histopathology as the reference standard. Additionally, correlations between HPV16 cycle threshold (Ct) values, HPV18 Ct values, and the severity of cervical lesions were analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic utility of HPV16 Ct values for CIN2+ lesions.</p><p><strong>Results: </strong>Compared with TCT or HR-HPV testing alone, the combined TCT and HR-HPV test had the highest sensitivity of 98.1% (<i>P</i> < 0.0001), the highest negative predictive value of 99.8% (<i>P</i> = 0.0001), and the lowest missed diagnosis rate of 1.9% (<i>P</i> < 0.0001) for screening CIN2+ lesions. Additionally, the combined test yielded the largest area under the ROC curve (AUC) value of 0.9480. There was a significant difference in HPV16 Ct values for various degrees of cervical lesions (<i>P</i> < 0.001), with the Spearman rank correlation test revealing a significant negative correlation (<i>rs</i> = -0.447, <i>P</i> < 0.001). The optimal HPV16 Ct value for diagnosing CIN2+ lesions was 29.995, with an AUC of 0.797 (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>The combination of TCT and HR-HPV testing was the most effective method for screening CIN2+ lesions. Furthermore, HPV16 Ct values were negatively correlated with the severity of cervical lesions, with a threshold of 29.995 potentially indicating the presence of CIN2+ lesions.</p>\",\"PeriodicalId\":14356,\"journal\":{\"name\":\"International Journal of Women's Health\",\"volume\":\"16 \",\"pages\":\"1959-1968\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-11-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587807/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Women's Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/IJWH.S488125\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Women's Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJWH.S488125","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
The Diagnostic Significance of Combined Screening and Human Papillomavirus 16 and 18 Cycle Threshold Values for CIN2+ Cervical Lesions.
Background: Although both cervical intraepithelial neoplasia (CIN) II and CIN III carry the potential to progress into cervical cancer, to date, an optimal screening method for CIN2+ (CIN II, CIN III, and cervical cancer) cervical lesions is yet to be established.
Methods: In this retrospective study, data from 2035 patients treated at the Fourth Hospital of Hebei Medical University between 2019 and 2021 were analyzed. The screening efficacy of three methods-the ThinPrep cytologic test (TCT) alone, the high-risk-human papillomavirus (HR-HPV) test alone, and the combined TCT and HR-HPV screening for CIN2+ lesions-were assessed using cervical histopathology as the reference standard. Additionally, correlations between HPV16 cycle threshold (Ct) values, HPV18 Ct values, and the severity of cervical lesions were analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic utility of HPV16 Ct values for CIN2+ lesions.
Results: Compared with TCT or HR-HPV testing alone, the combined TCT and HR-HPV test had the highest sensitivity of 98.1% (P < 0.0001), the highest negative predictive value of 99.8% (P = 0.0001), and the lowest missed diagnosis rate of 1.9% (P < 0.0001) for screening CIN2+ lesions. Additionally, the combined test yielded the largest area under the ROC curve (AUC) value of 0.9480. There was a significant difference in HPV16 Ct values for various degrees of cervical lesions (P < 0.001), with the Spearman rank correlation test revealing a significant negative correlation (rs = -0.447, P < 0.001). The optimal HPV16 Ct value for diagnosing CIN2+ lesions was 29.995, with an AUC of 0.797 (P < 0.0001).
Conclusion: The combination of TCT and HR-HPV testing was the most effective method for screening CIN2+ lesions. Furthermore, HPV16 Ct values were negatively correlated with the severity of cervical lesions, with a threshold of 29.995 potentially indicating the presence of CIN2+ lesions.
期刊介绍：
International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.
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