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绝经后妇女基于 HPV 的宫颈癌筛查中专业采样与自我采样的比较。

Comparison between professional sampling and self-sampling for HPV-based cervical cancer screening among postmenopausal women.

机构信息

Department of Women's Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

出版信息

Int J Gynaecol Obstet. 2018 Sep;142(3):359-364. doi: 10.1002/ijgo.12538. Epub 2018 Jun 25.

Abstract

OBJECTIVE

To investigate whether self-sampling is as reliable as professional sampling for HPV testing and genotype detection among postmenopausal women.

METHODS

In the present prospective cross-sectional study, women in Örebro County, Sweden, who had high-risk HPV (hrHPV) and normal cytology results in exit screening tests conducted in between January 1, 2012, and December 31, 2014, were invited to follow-up screenings between February 24, 2015 and May 15, 2015, that included professional sampling and self-sampling. HPV genotypes were identified by a DNA-based assay that could detect 35 HPV genotypes. Findings between the different sampling methods were compared.

RESULTS

Of 143 women who participated, 119 returned a self-sample. Completely concordant results were observed in 67 of these samples when both hrHPV and low-risk HPV genotypes were analyzed. Overall, 99 (83.2%) women had the same clinically relevant finding from both sampling methods. Twenty women had discordant hrHPV results (hrHPV detected in 10 self-samples vs 10 professionally collected samples; Cohen κ 0.66, 95% confidence interval 0.53-0.80). There was no significant difference between the two sampling methods for clinically significant infections (P>0.99) or extended genotyping (P=0.827).

CONCLUSION

Postmenopausal women could be offered self-sampling devices to increase screening-program coverage while maintaining test quality.

摘要

目的

研究绝经后妇女自我采样与专业采样在 HPV 检测和基因分型检测中的可靠性。

方法

在本前瞻性横断面研究中,邀请瑞典厄勒布鲁县于 2012 年 1 月 1 日至 2014 年 12 月 31 日期间接受出口筛查试验且高危型 HPV(hrHPV)和细胞学正常的女性参加 2015 年 2 月 24 日至 5 月 15 日之间的随访筛查,包括专业采样和自我采样。通过可检测 35 种 HPV 基因型的基于 DNA 的检测方法确定 HPV 基因型。比较不同采样方法的结果。

结果

143 名参与研究的女性中,有 119 名女性提交了自我采样。当同时分析 hrHPV 和低危型 HPV 基因型时,这些样本中有 67 个完全一致。总体而言,99(83.2%)名女性的两种采样方法具有相同的临床相关发现。20 名女性的 hrHPV 结果不一致(10 个自我样本和 10 个专业采集样本均检测到 hrHPV;Cohen κ 0.66,95%置信区间 0.53-0.80)。两种采样方法在临床显著感染(P>0.99)或扩展基因分型(P=0.827)方面无显著差异。

结论

可以为绝经后妇女提供自我采样设备,在保持检测质量的同时提高筛查计划的覆盖率。

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