Piyathilake Chandrika J, Badiga Suguna, Chambers Michelle M, Brill Ilene K, Matthews Roland, Partridge Edward E
Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
Cancer. 2016 Sep 15;122(18):2836-44. doi: 10.1002/cncr.30123. Epub 2016 May 31.
Although urine-based testing for human papillomavirus (HPV) is being explored as a practical approach for cervical cancer screening, whether the results differ by age, race, or indicators of excess body weight or in populations exposed to HPV vaccines has not been documented by previous studies. The purpose of this study was to determine the accuracy of urinary HPV testing for the presence of cervical HPVs and high-grade cervical intraepithelial lesions (grade 2 and 3 cervical intraepithelial neoplasia [CIN]) by the aforementioned population characteristics.
The study population consisted of 502 women diagnosed with different grades of CIN. HPV testing was performed with paired urine and cervical cell DNA with the Roche Diagnostics Linear Array test. Agreement coefficient 1 and probabilities were calculated to determine the accuracy of urinary HPV testing for the presence of cervical HPVs and CIN lesions.
Substantial to almost perfect agreement (0.66-0.83) was observed in the detection of any HPV genotype in urine specimens versus cervical specimens, regardless of the population characteristics. Although the positive predictive value for the detection of CIN lesions was relatively low, the negative predictive value for CIN-3 was high (≥90%) among women positive for any of the urinary or cervical high-risk human papillomavirus (HR-HPV) genotypes or HPV genotypes not included in currently available HPV vaccines.
The results demonstrate that urinary HPV testing provides highly satisfactory results for excluding the possibility of any cervical HPV infections, including HPV types not included in vaccines and CIN lesions associated with any HR-HPV, regardless of a woman's age, race, or excess body weight. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2836-2844. © 2016 American Cancer Society.
尽管基于尿液的人乳头瘤病毒（HPV）检测正作为宫颈癌筛查的一种实用方法进行探索，但此前的研究尚未记录其结果在年龄、种族、超重指标或接种HPV疫苗人群中是否存在差异。本研究的目的是根据上述人群特征确定尿液HPV检测对宫颈HPV及高级别宫颈上皮内病变（2级和3级宫颈上皮内瘤变 [CIN]）的诊断准确性。
研究人群包括502名被诊断为不同级别的CIN的女性。采用罗氏诊断线性阵列检测法对配对的尿液和宫颈细胞DNA进行HPV检测。计算一致性系数1和概率，以确定尿液HPV检测对宫颈HPV及CIN病变的诊断准确性。
无论人群特征如何，在尿液标本与宫颈标本中检测到的任何HPV基因型方面，均观察到高度一致至几乎完全一致（0.66 - 0.83）。尽管检测CIN病变的阳性预测值相对较低，但在尿液或宫颈高危人乳头瘤病毒（HR - HPV）基因型或现有HPV疫苗未包含的HPV基因型检测呈阳性的女性中，CIN - 3的阴性预测值较高（≥90%）。
结果表明，无论女性的年龄、种族或超重情况如何，尿液HPV检测在排除任何宫颈HPV感染的可能性方面提供了高度令人满意的结果，包括疫苗未包含的HPV类型以及与任何HR - HPV相关的CIN病变。癌症2016。©2016美国癌症协会。癌症2016；122：2836 - 2844。©2016美国癌症协会。
