Harper Diane M, Longacre Meghan R, Noll Walter W, Belloni Dorothy R, Cole Bernard F
Department of Obstetrics and Gynecology, Dartmouth Medical School, Hanover, NH, USA.
Ann Fam Med. 2003 Nov-Dec;1(4):221-7. doi: 10.1370/afm.90.
Maximizing the accuracy of human papillomavirus (HPV) detection from a single sample is important for clinical and research purposes. The purpose of this study was to determine whether cyclic hormonal variation, recent sexual intercourse, interval between samplings, and the technique used to sample affect the detection of HPV.
This study was a prospective, longitudinal, randomized controlled trial. Three techniques for self-sampling (2 consecutive synthetic polyester fiber [Dacron] swabs, a single Dacron swab, and a tampon) were repeated at 3 different sampling times during a period of 4 to 6 weeks in addition to 1 clinician-directed sampling of the ectocervix and endocervix at the first sampling time. All self-samplings were taken in a proscribed randomized order. Women (aged 18 to 68 years) attending a colposcopy clinic for abnormal cytology or abnormal cervical appearance participated in the study. The outcome measure was the detection of HPV by polymerase chain reaction amplification.
The 103 participants provided 1,189 cervicovaginal samplings. Logistic regression indicated that intercourse within 48 hours of sampling did not result in a greater detection of high-risk or any HPV type (odds ratio [OR] = 1.05, 95% confidence interval [CI], 0.65-1.69; OR = 1.08, 95% CI, 0.73-1.60, respectively). Among those women who have regular menstrual cycles, there was no cyclic effect on HPV detection for high-risk and any HPV types. Time from previous sampling did not affect HPV detection. Among the self-sampling techniques, using a single self-swab and the tampon resulted in the detection of HPV between 10% and 35% less often than using 2 consecutive swabs (P < .025). Self-sampling with 2 swabs was not significantly different from clinician sampling for detecting high-risk HPV types (OR for self-sampling = 0.87 (95% CI, 0.66-1.13)).
HPV detection is not dependent on menstrual cycle timings, the recency of intercourse, or the time between samplings, but it is dependent on the sampling technique.
对于临床和研究目的而言，最大化单次样本中人乳头瘤病毒（HPV）检测的准确性非常重要。本研究的目的是确定周期性激素变化、近期性行为、采样间隔以及采样技术是否会影响HPV的检测。
本研究为前瞻性、纵向、随机对照试验。除了在首次采样时由临床医生对宫颈外口和宫颈管进行一次采样外，在4至6周的时间内，在3个不同的采样时间重复3种自我采样技术（连续2根合成聚酯纤维[涤纶]拭子、1根涤纶拭子和1个卫生棉条）。所有自我采样均按规定的随机顺序进行。到阴道镜门诊就诊的因细胞学异常或宫颈外观异常的18至68岁女性参与了本研究。观察指标是通过聚合酶链反应扩增检测HPV。
103名参与者提供了1189次宫颈阴道采样。逻辑回归表明，采样前48小时内的性行为并未导致高危型或任何HPV类型的检测率更高（优势比[OR]=1.05，95%置信区间[CI]，0.65-1.69；OR=1.08，95%CI，0.73-1.60）。在月经周期规律的女性中，高危型和任何HPV类型的检测均无周期性影响。距上次采样的时间不影响HPV检测。在自我采样技术中，使用单根自我拭子和卫生棉条检测到HPV的频率比使用连续2根拭子低10%至35%（P<0.025）。在检测高危型HPV类型方面，使用2根拭子进行自我采样与临床医生采样无显著差异（自我采样的OR=0.87（95%CI，0.66-1.13））。
HPV检测不依赖于月经周期时间、性行为近期情况或采样间隔，但依赖于采样技术。
