肯尼亚高危女性中用于检测宫颈病变的医师采集和自我采集标本的高危型人乳头瘤病毒信使核糖核酸检测

High-risk human papillomavirus messenger RNA testing in physician- and self-collected specimens for cervical lesion detection in high-risk women, Kenya.

作者信息

Ting Jie, Mugo Nelly, Kwatampora Jessie, Hill Craig, Chitwa Michael, Patel Suha, Gakure Hannah, Kimani Joshua, Schoenbach Victor J, Poole Charles, Smith Jennifer S

机构信息

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

出版信息

Sex Transm Dis. 2013 Jul;40(7):584-9. doi: 10.1097/OLQ.0b013e31828e5a91.

DOI:10.1097/OLQ.0b013e31828e5a91

PMID:23965776

Abstract

BACKGROUND

Little is known about the performance of physician-versus self-collected specimens for high-risk human papillomavirus (hrHPV) messenger RNA (mRNA) testing or risk factors for hrHPV mRNA positivity in physician- versus self-collected specimens. We compared the performance of hrHPV mRNA testing of physician- and self-collected specimens for detecting cytological high-grade squamous intraepithelial lesions or more severe (≥HSIL) and examined risk factors for hrHPV mRNA positivity in female sex workers in Nairobi.

METHODS

From 2009 to 2011, 344 female sex workers participated in this cross-sectional study. Women self-collected a cervicovaginal specimen. A physician conducted a pelvic examination to obtain a cervical specimen. Physician- and self-collected specimens were tested for hrHPV mRNA and sexually transmitted infections using APTIMA nucleic acid amplification assays (Hologic/Gen-Probe Incorporated, San Diego, CA). Cervical cytology was conducted using physician-collected specimens and classified according to the Bethesda criteria.

RESULTS

Overall hrHPV mRNA prevalence was similar in physician- and self-collected specimens (30% vs. 29%). Prevalence of ≥HSIL was 4% (n = 15). Overall sensitivity of hrHPV testing for detecting ≥HSIL was similar in physician-collected (86%; 95% CI, 62%-98%; 13 cases detected) and self-collected specimens (79%; 95% CI, 55%-95%; 12 cases detected). Overall specificity of hrHPV mRNA for ≥HSIL was similar in both physician-collected (73%; 95% CI, 68%-79%) and self-collected (75%; 95% CI, 70%-79%) specimens. High-risk HPV mRNA positivity in both physician- and self-collected specimens seemed higher in women who were younger (<30 years), had Trichomonas vaginalis or Mycoplasma genitalium infections, or had more than 8 years of educational attainment.

CONCLUSIONS

Self-collected specimens for hrHPV mRNA testing seemed to have similar sensitivity and specificity as physician-collected specimens for the detection of ≥HSIL among high-risk women.

摘要

背景

对于高危型人乳头瘤病毒（hrHPV）信使核糖核酸（mRNA）检测中医生采集样本与自我采集样本的表现，以及医生采集样本与自我采集样本中hrHPV mRNA阳性的风险因素，人们了解甚少。我们比较了医生采集样本与自我采集样本进行hrHPV mRNA检测以发现细胞学高级别鳞状上皮内病变或更严重病变（≥HSIL）的表现，并研究了内罗毕女性性工作者中hrHPV mRNA阳性的风险因素。

方法

2009年至2011年，344名女性性工作者参与了这项横断面研究。女性自行采集一份宫颈阴道样本。医生进行盆腔检查以获取宫颈样本。使用APTIMA核酸扩增检测法（Hologic/Gen-Probe Incorporated，加利福尼亚州圣地亚哥）对医生采集样本与自我采集样本进行hrHPV mRNA和性传播感染检测。使用医生采集的样本进行宫颈细胞学检查，并根据贝塞斯达标准进行分类。

结果

医生采集样本与自我采集样本中hrHPV mRNA总体患病率相似（分别为30%和29%）。≥HSIL的患病率为4%（n = 15）。医生采集样本（86%；95%CI，62%-98%；检测到13例）与自我采集样本（79%；95%CI，55%-95%；检测到12例）中hrHPV检测发现≥HSIL的总体敏感性相似。医生采集样本（73%；95%CI，68%-79%）与自我采集样本（75%；95%CI，70%-79%）中hrHPV mRNA对≥HSIL的总体特异性相似。年龄小于30岁、感染阴道毛滴虫或生殖支原体或受教育年限超过8年的女性，其医生采集样本与自我采集样本中的高危型HPV mRNA阳性率似乎更高。