用于人乳头瘤病毒DNA检测的自我采样：玻利维亚的依从性和可行性初步研究
Self-sampling for human papillomavirus DNA detection: a preliminary study of compliance and feasibility in BOLIVIA.
作者信息
Surriabre Pedro, Allende Gustavo, Prado Marcela, Cáceres Leyddy, Bellot Diego, Torrico Andrea, Ustariz Karina, Rojas Shirley, Barriga Jaime, Calle Pamela, Villarroel Ligia, Yañez Rosse Mary, Baay Marc, Rodriguez Patricia, Fontaine Véronique
机构信息
Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia.
Unité de Microbiologie Pharmaceutique et Hygiène, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium.
出版信息
BMC Womens Health. 2017 Dec 22;17(1):135. doi: 10.1186/s12905-017-0490-z.
BACKGROUND
Cervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America. This investigation aims to evaluate the possibility of using simple devices, e.g. a cotton swab and a glass slide, for self-sampling in order to detect human papillomavirus (HPV) DNA by PCR in cervico-vaginal cells.
METHODS
In the first phase of our study we evaluated the use of a glass slide as a transport medium for cervical cells. A physician took paired-cervical samples from 235 women. One sample was transported in Easyfix® solution and the other sample was smeared over a glass slide. Both were further analyzed and compared for human DNA recovery and HPV detection. A kappa value was determined to evaluate the agreement between the HPV DNA detection rates. In the second phase of the study, 222 women from the urban, peri-urban and rural regions of Cochabamba were requested to perform self-sampling using the following devices: a cotton swab combined with a glass slide, and a vaginal tampon. Women gave their opinion about the self-sampling technique. Finally, the agreement for high risk-HPV detection between self- and physician-collected samples was performed in 201 samples in order to evaluate the self-sampling technique.
RESULTS
Firstly, the comparison between Easyfix® solution and the glass slide to transport clinical samples gave a good agreement for HPV DNA detection (κ = 0.71, 95% CI 0.60-0.81). Secondly, self-sampling, especially with cotton swab combined with glass slide, would generally be preferred over clinician sampling for a screening program based on HPV detection. Finally, we showed a good agreement between self- and physician collected samples for high risk-HPV detection (κ = 0.71, 95% CI 0.55-0.88).
CONCLUSIONS
Simple devices such as a cotton swab and a glass slide can be used to perform self-sampling and HPV DNA detection. Furthermore, most Bolivian women preferred self-sampling over clinician-sampling for cervical cancer screening.
背景
玻利维亚的宫颈癌发病率和死亡率在拉丁美洲位居前列。本研究旨在评估使用简单设备（如棉拭子和载玻片）进行自我采样，以便通过聚合酶链反应（PCR）检测宫颈阴道细胞中人乳头瘤病毒（HPV）DNA的可能性。
方法
在研究的第一阶段，我们评估了载玻片作为宫颈细胞转运介质的用途。一名医生从235名女性中采集了配对的宫颈样本。一个样本用Easyfix®溶液转运，另一个样本涂抹在载玻片上。对两者进行进一步分析，并比较人类DNA回收率和HPV检测情况。通过kappa值评估HPV DNA检测率之间的一致性。在研究的第二阶段，要求来自科恰班巴市、城郊和农村地区的222名女性使用以下设备进行自我采样：与载玻片结合的棉拭子和阴道棉塞。女性对自我采样技术发表了意见。最后，对201个样本进行自我采集和医生采集样本之间高危HPV检测的一致性评估，以评价自我采样技术。
结果
首先，比较用Easyfix®溶液和载玻片转运临床样本时，HPV DNA检测结果具有良好的一致性（κ = 0.71，95%可信区间0.60 - 0.81）。其次，对于基于HPV检测的筛查项目，自我采样，尤其是棉拭子与载玻片结合使用的方式，总体上比临床医生采样更受青睐。最后，我们发现自我采集和医生采集样本在高危HPV检测方面具有良好的一致性（κ = 0.71，95%可信区间0.55 - （此处原文有误，应为0.87）0.88）。
结论
棉拭子和载玻片等简单设备可用于进行自我采样和HPV DNA检测。此外，大多数玻利维亚女性在宫颈癌筛查中更喜欢自我采样而非临床医生采样。
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