Department of Gynaecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany.
J Virol Methods. 2013 Oct;193(1):131-4. doi: 10.1016/j.jviromet.2013.05.009. Epub 2013 May 23.
Self-collection of cervical samples for human papillomavirus (HPV) testing can help to raise the participation rate in cervical cancer screening among non-responders. This study was conducted to compare the analytical and clinical performance of the Abbott RealTime High-Risk HPV Test (RealTime) with the Hybrid Capture 2 assay (HC2) on self-collected cervicovaginal lavage samples. One hundred samples from women referred for colposcopy (reference smears and biopsies in case of abnormalities) were included. Fifty-seven women had a normal cytology, 27 had low grade and 16 had high grade squamous intraepithelial lesions. Fourteen of 49 biopsies (28.6%) were benign, 14 (28.6%) cervical intraepithelial neoplasia 1, 11 (22.4%) cervical intraepithelial neoplasia 2, 8 (16.3%) cervical intraepithelial neoplasia 3 and 2 (4.1%) invasive cancer. The agreement between RealTime and HC2 in the self-collected and in the reference samples was 85% (κ=0.665) and 83% (κ=0.620), respectively. The agreement between self-sampling and the reference smears was higher with RealTime (93%; κ=0.849) than with HC2 (89%; κ=0.741). In the self-collected samples, the sensitivity and specificity for cervical intraepithelial neoplasia 2 or worse of RealTime/HC2 were 81.0%/66.7% (p=0.25) and 53.6%/57.1%, respectively. The sensitivity for cervical intraepithelial neoplasia 3 or worse of RealTime and HC2 were 80.0% and 70.0% (p=1.0). The specificity for cervical intraepithelial neoplasia 3 or worse was 43.6% (RealTime) and 51.3% (HC2). This study shows that RealTime can be used for HR-HPV testing of self-collected lavage samples in a referral population with at least equal quality and performance as HC2.
自我采集的宫颈样本进行人乳头瘤病毒(HPV)检测有助于提高非应答者的宫颈癌筛查参与率。本研究旨在比较 Abbott RealTime 高危型 HPV 检测(RealTime)与杂交捕获 2 检测(HC2)在自我采集的宫颈阴道灌洗样本中的分析和临床性能。共纳入 100 例转诊行阴道镜检查的女性(如有异常则进行参考涂片和活检)。57 例女性细胞学检查正常,27 例低度病变,16 例高度鳞状上皮内病变。49 例活检中 14 例(28.6%)为良性,14 例(28.6%)为宫颈上皮内瘤变 1 级,11 例(22.4%)为宫颈上皮内瘤变 2 级,8 例(16.3%)为宫颈上皮内瘤变 3 级,2 例(4.1%)为浸润性癌。RealTime 与 HC2 在自我采集样本和参考样本中的一致性分别为 85%(κ=0.665)和 83%(κ=0.620)。RealTime 与参考涂片的自我采样一致性更高(93%;κ=0.849),而 HC2 为 89%(κ=0.741)。在自我采集样本中,RealTime/HC2 对宫颈上皮内瘤变 2 级或更高级别病变的敏感性和特异性分别为 81.0%/66.7%(p=0.25)和 53.6%/57.1%。RealTime 和 HC2 对宫颈上皮内瘤变 3 级或更高级别病变的敏感性分别为 80.0%和 70.0%(p=1.0)。宫颈上皮内瘤变 3 级或更高级别病变的特异性分别为 43.6%(RealTime)和 51.3%(HC2)。本研究表明,RealTime 可用于高危型 HPV 检测,其在转诊人群中自我采集的灌洗样本中的质量和性能与 HC2 相当。