Armando Baena, Maria Alejandra Picconi, Laura Mendoza, Annabelle Ferrera, David Mesher, Johana Lineros, Marisol Brizuela, Pamela Mongelos, Yessy Cabrera, Maria Dolores Fellner, Osmalia Zambrana, Laura García, Pilar Hernández, Maria Liz Bobadilla, Maria Ramon, Gino Venegas, Verónica Villagra, Aurelio Cruz, Guillermo Rodríguez, Carolina Terán, Alejandro Calderón, Carolina Wiesner, Rolando Herrero, Maribel Almonte
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Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18).</p><p><strong>Results: </strong>Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2-2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2-85.2) for HC2 and 87.7% (83.7-90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7-59.0) and 68.2% (66.1-70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. 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引用次数: 0
摘要
背景：持续的HPV感染可导致宫颈癌，但大多数感染是短暂的。分诊方法确定需要进一步评估或治疗的高危妇女。我们评估了短期重复HPV检测作为另一种分诊选择。方法：在ESTAMPA， 30-64岁的女性接受HPV检测（HC2或Cobas）和细胞学筛查。筛查阳性的患者在筛查后大约两个月接受阴道镜检查，再次收集宫颈样本进行HPV检测。我们评估了HPV阳性女性中CIN3+重复HPV的表现，并探讨了其与有限HPV基因分型（HPV16/18）的结合。结果：5390例hpv阳性妇女（包括629例CIN3病例和53例癌症）中，61%在2个月后复检阳性（中位数：1.8，四分位数范围：1.2-2.8）。HC2对CIN3+的重复HPV敏感性为81.5% (95% CI 77.2-85.2)， Cobas为87.7%（83.7-90.8）。结论：短期重复HPV检测可能是诊断HPV阳性妇女的实用选择，无论是单独检测还是结合有限的HPV基因分型。试验注册：ClinicalTrials.gov, NCT01881659。
Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening.
Background: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option.
Methods: In ESTAMPA, women aged 30-64 years were screened with HPV testing (HC2 or Cobas) and cytology. Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18).
Results: Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2-2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2-85.2) for HC2 and 87.7% (83.7-90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7-59.0) and 68.2% (66.1-70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. However, HPV16/18 positivity doubled the risk of CIN3+, supporting its combination with repeat HPV when available.
Conclusions: Short-term repeat HPV testing could be a practical option for triaging HPV-positive women, either alone or in combination with limited HPV genotyping.
期刊介绍：
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.
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