Kir Gozde, Seneldir Hatice, Cosan Sarbay Billur
Pathology Department, İstanbul Medeniyet University Göztepe Research and Training Hospital, Istanbul, Turkey.
Pathology Department, Denizli State Hospital, Denizli, Turkey.
Diagn Cytopathol. 2018 Jan;46(1):3-8. doi: 10.1002/dc.23836. Epub 2017 Oct 12.
We aimed to compare the performance of computer-assisted liquid-based cytology, primary high-risk human papillomavirus (hrHPV) screening, and cytology-hrHPV cotesting with regards to the detection rate of cervical cancer precursor lesions.
A total of 22,653 computer-assisted liquid-based cytology specimens interpreted between 2013 and 2015 were included in the study. We compared the false-negative rates and sensitivities for computer-assisted liquid-based cytology, primary hrHPV screening and cytology-hrHPV cotesting among women with normal and abnormal cytologies. Among 1,748 women who had undergone cotesting, 249 underwent follow-up biopsies.
For detecting biopsy-confirmed high-grade lesions, the sensitivities of using hrHPV, Pap tests, and cytology-hrHPV cotesting were 90.67%, 88%, and 98.67%, respectively, while the false-negative rates for hrHPV and Pap tests were 9.3% and 12%, respectively. The false negative rate for cotesting was only 1.3%.
Based on the significantly high sensitivity and lower false-negative rates achieved, we conclude that the combination of cytologic screening with hrHPV testing is the best preferred strategy for detection of cervical precursor lesions in our country's conditions.
我们旨在比较计算机辅助液基细胞学检查、原发性高危型人乳头瘤病毒（hrHPV）筛查以及细胞学-hrHPV联合检测在宫颈癌前病变检出率方面的表现。
本研究纳入了2013年至2015年间解读的共计22,653份计算机辅助液基细胞学标本。我们比较了细胞学正常和异常女性中计算机辅助液基细胞学检查、原发性hrHPV筛查以及细胞学-hrHPV联合检测的假阴性率和敏感性。在1,748名接受联合检测的女性中，249人接受了后续活检。
对于检测经活检确认的高级别病变，使用hrHPV、巴氏试验以及细胞学-hrHPV联合检测的敏感性分别为90.67%、88%和98.67%，而hrHPV和巴氏试验的假阴性率分别为9.3%和12%。联合检测的假阴性率仅为1.3%。
基于所实现的显著高敏感性和较低假阴性率，我们得出结论，在我国的情况下，细胞学筛查与hrHPV检测相结合是检测宫颈前体病变的最佳首选策略。
