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[评估 cobas 4800 高危型人乳头瘤病毒检测作为宫颈癌筛查和细胞学分流工具的效果]

[Evaluation of cobas 4800 high-risk HPV test as a tool in cervical cancer screening and cytology triage].

作者信息

Chen Wen, Yu Lu-lu, Wang Hong, Fu Chun-jing, Chen Feng, Cao Yan-qing, Kang Le-ni, Zhang Xun, Zhao Fang-hui, Geng Li, Yu Li

机构信息

Department of Epidemiology, Cancer Hospital & Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2012 Jul;34(7):543-8. doi: 10.3760/cma.j.issn.0253-3766.2012.07.014.

Abstract

OBJECTIVE

To evaluate the feasibility and reliability of cobas 4800 HPV test for cervical cancer screening and cytology referral.

METHODS

cobas 4800 HPV test and hybrid capture 2 (HC-2) were used to detect high risk HPV DNA in 670 specimens of liquid-based cytology collected from three hospitals. The agreement between cobas and HC-2 tests was assessed. HPV PCR detection (HybriBio) and gene sequencing were used for genotyping, and the agreement of HPV16 and 18 genotyped by cobas and HybriBio was evaluated. Histological diagnosis was considered as a gold standard to estimate the sensitivity and specificity of cobas vs. HC-2 in detecting CIN2(+) in cervical lesions.

RESULTS

The crude agreement between cobas and HC-2 tests was 89.40%, the Kappa value was 0.778, the positive concordance rate was 86.42%, and the negative concordance rate was 91.36%. The crude agreement rates between cobas and HybriBio on HPV16 and 18 were 88.89% and 94.94%, the Kappa values were 0.777 and 0.753, the positive concordance rates were 98.91% and 100.00%, and the negative concordance rates were 78.41% and 94.44%, respectively. HPV PCR detection (HybriBio) and gene sequencing were considered as adjusted standard: the high risk HPV positive concordance rate was 100%, negative coincidence rate was 94.42%, HPV16 and 18 positive concordance rates were both 100%, and negative concordance rates were 82.35% and 94.44%, respectively. Regarding the detection of CIN2(+), the sensitivity and specificity were 91.07% and 70.97% for cobas, and 93.75% and 71.33% for HC-2, with a non-significant difference between the results of the two tests (P > 0.05).

CONCLUSIONS

cobas4800 HPV test has good screening sensitivity and specificity in correct detection of HPV16 and 18 and other high-risk HPV virus types.

摘要

目的

评估 cobas 4800 HPV 检测用于宫颈癌筛查及细胞学转诊的可行性和可靠性。

方法

采用 cobas 4800 HPV 检测和杂交捕获 2(HC-2)法,对从三家医院收集的 670 份液基细胞学标本中的高危型 HPV DNA 进行检测。评估 cobas 检测与 HC-2 检测之间的一致性。采用 HPV PCR 检测(HybriBio)和基因测序进行基因分型,并评估 cobas 与 HybriBio 对 HPV16 和 18 基因分型的一致性。以组织学诊断作为金标准,评估 cobas 与 HC-2 在检测宫颈病变中 CIN2(+)方面的敏感性和特异性。

结果

cobas 检测与 HC-2 检测的总体一致性为 89.40%,Kappa 值为 0.778,阳性符合率为 86.42%,阴性符合率为 91.36%。cobas 与 HybriBio 在 HPV16 和 18 基因分型上的总体符合率分别为 88.89%和 94.94%,Kappa 值分别为 0.777 和 0.753,阳性符合率分别为 98.91%和 100.00%,阴性符合率分别为 78.41%和 94.44%。以 HPV PCR 检测(HybriBio)和基因测序作为校正标准:高危型 HPV 阳性符合率为 100%,阴性符合率为 94.42%,HPV16 和 18 阳性符合率均为 100%,阴性符合率分别为 82.35%和 94.44%。在检测 CIN2(+)方面,cobas 的敏感性和特异性分别为 91.07%和 70.97%,HC-2 的敏感性和特异性分别为 93.75%和 71.33%,两种检测结果差异无统计学意义(P > 0.05)。

结论

cobas4800 HPV 检测在正确检测 HPV16 和 18 以及其他高危型 HPV 病毒类型方面具有良好的筛查敏感性和特异性。

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