Naizhaer Gulimire, Yuan Jianlin, Mijiti Patima, Aierken Kailibinuer, Abulizi Guzhalinuer, Qiao Youlin
The Third Department of Gynecology.
The Fifth Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang.
Medicine (Baltimore). 2020 Feb;99(6):e19135. doi: 10.1097/MD.0000000000019135.
This study is to evaluate the screening methods of cervical cancers for rural females in Kash bachu, Xinjiang, China.A total number of 3000 married females were surveyed, and subjected to the gynecological examination. In these subjects, 1993 females received the careHPV (human papillomavirus) test, while 1007 females underwent the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI). The subjects positive for careHPV detection were subjected to Cervista, Cobas 4800, and Aptima HPV detection, and Thinprep Cytologic Test (TCT). The subjects positive for 1 detection only received colposcopy cervical biopsy.A total of 569 subjects received the cervical biopsy, and the positive rate was 2.3% (69/3000), while the detection rate for CIN (cervical intraepithelial neoplasia) II and above levels was 1.13% (34/3000). Receiver operator characteristic (ROC) curve analysis showed that, the area under the curve (AUC) value for the careHPV test was 0.671, which was higher than the VIA/VILI (0.619), suggesting higher diagnostic value for the careHPV test. For the Cervista, Cobas 4800, Aptima HPV detection, and TCT methods, the highest AUC value was observed for the TCT method, indicating that the TCT method is the most valuable for the cervical cancer screening.The diagnostic value of careHPV test is superior to the VIA/VILA detection method. The TCT method has the greatest value for the cervical cancer screening. The Cervista HPV detection method should be considered where the conditions are limited.
本研究旨在评估中国新疆喀什巴楚县农村女性宫颈癌的筛查方法。共对3000名已婚女性进行了调查，并进行了妇科检查。在这些受试者中，1993名女性接受了careHPV（人乳头瘤病毒）检测，而1007名女性接受了醋酸肉眼检查（VIA）和卢戈氏碘液肉眼检查（VILI）。careHPV检测呈阳性的受试者接受了Cervista、Cobas 4800和Aptima HPV检测以及薄层液基细胞学检测（TCT）。仅1项检测呈阳性的受试者仅接受了阴道镜宫颈活检。共有569名受试者接受了宫颈活检，阳性率为2.3%（69/3000），而CIN（宫颈上皮内瘤变）II级及以上水平的检出率为1.13%（34/3000）。受试者工作特征（ROC）曲线分析表明，careHPV检测的曲线下面积（AUC）值为0.671，高于VIA/VILI（0.619），提示careHPV检测具有更高的诊断价值。对于Cervista、Cobas 4800、Aptima HPV检测和TCT方法，TCT方法的AUC值最高，表明TCT方法对宫颈癌筛查最有价值。careHPV检测的诊断价值优于VIA/VILA检测方法。TCT方法对宫颈癌筛查价值最大。在条件有限的地方应考虑采用Cervista HPV检测方法。
