Winer Rachel L, Feng Qinghua, Hughes James P, Yu Mujun, Kiviat Nancy B, O'Reilly Sandra, Koutsky Laura A
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Sex Transm Dis. 2007 Jun;34(6):371-7. doi: 10.1097/01.olq.0000240315.19652.59.
The objective of this study was to determine whether self- and clinician-collected samples are comparable for human papillomavirus (HPV) detection.
Three hundred seventy-four women aged 23 to 32 (population 1) and 211 women aged 18 to 25 (population 2) contributed self-collected vaginal and clinician-collected cervical and vulvovaginal samples for HPV DNA testing. Eighty-six women mailed in self-collected samples.
Agreement between self-collected vaginal and clinician-collected combined cervical/vulvovaginal samples was excellent (population 1:92.0%, kappa = 0.81; population 2: 96.4%, kappa = 0.88), but self-collected samples were more concordant with clinician-collected cervical samples in population 2 (kappa = 0.84) than population 1 (kappa = 0.65) (P = 0.01). Age-adjusted HPV prevalence was slightly lower in mailed-in (21.5%) than in-clinic self-collected samples (26.8%).
The combined clinician-collected cervical/vulvovaginal sample is most sensitive for detecting all female genital tract HPV infections. HPV concordance between cervical and vaginal samples may be better for newer infections. Larger studies are needed to determine whether mailed-in self-samples are as effective as those collected in a clinical setting.
本研究的目的是确定自我采集和临床医生采集的样本在人乳头瘤病毒（HPV）检测方面是否具有可比性。
374名年龄在23至32岁之间的女性（群体1）和211名年龄在18至25岁之间的女性（群体2）提供了自我采集的阴道样本以及临床医生采集的宫颈和外阴阴道样本用于HPV DNA检测。86名女性邮寄了自我采集的样本。
自我采集的阴道样本与临床医生采集的宫颈/外阴阴道联合样本之间的一致性非常好（群体1：92.0%，kappa = 0.81；群体2：96.4%，kappa = 0.88），但在群体2中，自我采集的样本与临床医生采集的宫颈样本的一致性（kappa = 0.84）高于群体1（kappa = 0.65）（P = 0.01）。经年龄调整后的HPV患病率在邮寄样本中（21.5%）略低于临床自我采集的样本（26.8%）。
临床医生采集的宫颈/外阴阴道联合样本在检测所有女性生殖道HPV感染方面最为敏感。宫颈和阴道样本之间HPV的一致性对于新感染可能更好。需要进行更大规模的研究来确定邮寄的自我样本是否与在临床环境中采集的样本一样有效。
