Zhang S K, Zhao D M, Chen H M, Guo Z, Ren L Y, Jia M M, Chang J J, Chen P P, Liu S Z, Sun X B
Office of Henan Cancer Certer, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Sep 6;52(9):941-945. doi: 10.3760/cma.j.issn.0253-9624.2018.09.014.
To evaluate the performance of high risk human papillomavirus (HR-HPV) DNA test for triage ASC-US in Chinese population. The study population was from Jiyuan city in Henan Province where a cervical cancer screening cohort (4 026 women) was set up from April to July in 2017. Women with ASC-US and complete recall information of colposcope were selected as the study objects. Self-designed questionnaire was used to survey the general information and medical history of cervical cancer, thencervical cytological speciments were collected for cytodiagnosis and HPV DNA test, followed by colposcopy, lesion biopsy and histology diagnose. The diagnosis of histology was used as the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as well as corresponding 95% confidential interval () were calculated. The average age of the included 393 women with ASC-US were (50.81±9.22) years old. The positivity of high risk human papillomavirus (HR-HPV), HPV16 and HPV18 were 35.6%, 10.69% and 2.80%, respectively. The sensitivity, specificity, PPV and NPV for HR-HPV to detect CIN2+ were 84.38% (68.25%-93.14%), 68.70% (63.74%-73.26%), 19.29% (13.61%-26.61%) and 98.02% (95.46%-99.15%). When compared with HR-HPV, HPV16/18 had a lower sensitivity (59.38% (42.26%-74.48%)) and a higher specificity(91.14% (87.75%-93.65%)), the PPV and NPV were 59.38% (25.32%-50.98%) and 91.14% (93.61%-97.77%). It was more effective for HR-HPV to triage ASC-US than HPV16/18. In order to improve the effect of HPV16/18, it should include more HR-HPV types which were more prevalent in Chinese population.
评估高危型人乳头瘤病毒（HR-HPV）DNA检测在中国人群中对非典型鳞状细胞意义不明确（ASC-US）分流的性能。研究人群来自河南省济源市，2017年4月至7月在此建立了一个宫颈癌筛查队列（4026名女性）。选择有ASC-US且阴道镜检查召回信息完整的女性作为研究对象。采用自行设计的问卷对宫颈癌的一般信息和病史进行调查，然后收集宫颈细胞学标本进行细胞诊断和HPV DNA检测，随后进行阴道镜检查、病变活检和组织学诊断。组织学诊断作为金标准。计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以及相应的95%置信区间（）。纳入的393例ASC-US女性的平均年龄为（50.81±9.22）岁。高危型人乳头瘤病毒（HR-HPV）、HPV16和HPV18的阳性率分别为35.6%、10.69%和2.80%。HR-HPV检测高级别鳞状上皮内病变（CIN2+）的敏感性、特异性、PPV和NPV分别为84.38%（68.25%-93.14%）、68.70%（63.74%-73.26%）、19.29%（13.61%-26.61%）和98.02%（95.46%-99.15%）。与HR-HPV相比，HPV16/18的敏感性较低（59.38%（42.26%-74.48%）），特异性较高（91.14%（87.75%-93.65%）），PPV和NPV分别为59.38%（25.32%-50.98%）和91.14%（93.61%-97.77%）。HR-HPV对ASC-US的分流效果比HPV16/18更好。为了提高HPV16/18的效果，应纳入更多在中国人群中更常见的HR-HPV类型。
