Satake Hideo, Inaba Noriyuki, Kanno Keiichiro, Mihara Masato, Takagi Yoshitake, Kondo Nobuo, Sagae Satoru
GeneticLab Co., Ltd., Sapporo, Japan.
GeneticLab Co., Ltd., Sapporo, Japan,
Acta Cytol. 2020;64(5):433-441. doi: 10.1159/000507342. Epub 2020 May 12.
The objective of this study was to calculate the positive rate and overall concordance rate of high-risk human papillomavirus (hrHPV) test and cytology using self-sampled and physician-sampled cervicovaginal tests and to compare both specimens.
In collaboration with 3 private hospitals in Sapporo city, 300 women visiting these organizations were enrolled in the study by previously signing an informed consent. From these women, both types of samples (self-obtained and physician-sampled) were obtained at the same time. HrHPV test and cytology were performed on both specimens, and the positive rate and overall concordance rate were calculated to compare both specimens.
HrHPV-positive women were 13.7% in physician-sampled specimens and 14.7% in self-sampled specimens, with an overall concordance rate of 96.3% (95% confidence interval [CI]: 94-98%). On the other hand, the positive rate of the cases higher than or equal to atypical squamous cells of undetermined significance (ASCUS) on cytology was different between both groups, that is, 12.3% in physician-obtained and 5.3% in self-sampled specimens; the overall concordance rate was 90.7% (95% CI: 87-94%), indicating an apparent decrease in the positive rate of cytology in self-obtained specimens.
HrHPV test and cytology were performed on parallel samples obtained by the patients with a self-sampling tool and by the physician. The positive rate of cytology was considerably different between these specimens, while almost equivalent results were obtained for hrHPV test in both specimens. It was concluded that hrHPV test may be safely and accurately performed on self-obtained cervicovaginal samples by the help of a self-sampling device in the Japanese population as a first screening tool, with equivalent results to physician-obtained specimens.
本研究的目的是计算使用自我采集和医生采集的宫颈阴道样本进行高危型人乳头瘤病毒(hrHPV)检测和细胞学检查的阳性率及总体一致性率,并比较两种样本。
与札幌市的3家私立医院合作,通过事先签署知情同意书,招募了300名到这些机构就诊的女性参与研究。从这些女性中同时获取两种样本(自我采集和医生采集)。对两种样本都进行hrHPV检测和细胞学检查,并计算阳性率和总体一致性率以比较两种样本。
医生采集样本中hrHPV阳性女性占13.7%,自我采集样本中占14.7%,总体一致性率为96.3%(95%置信区间[CI]:94 - 98%)。另一方面,两组细胞学检查中高于或等于意义不明确的非典型鳞状细胞(ASCUS)病例的阳性率不同,即医生采集样本中为12.3%,自我采集样本中为5.3%;总体一致性率为90.7%(95% CI:87 - 94%),表明自我采集样本中细胞学检查的阳性率明显降低。
使用自我采样工具和医生分别获取的平行样本进行hrHPV检测和细胞学检查。这些样本中细胞学检查的阳性率有显著差异,而两种样本的hrHPV检测结果几乎相同。得出结论,在日本人群中,借助自我采样装置,hrHPV检测可以安全、准确地在自我采集的宫颈阴道样本上进行,作为初次筛查工具,结果与医生采集的样本相当。